Organization
SPARK CENTER FOR PSYCHOLOGY, INC.
Active
Other names
The Spark Center, Spark Center for Self Development, Spark Center for Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA VACCARO PSYD (PRESIDENT)
(916) 616-8561
Entity
Organization
Contact information
Practice address
1412 S ST STE 100, SACRAMENTO, CA 95811-7155
(916) 616-8561
(916) 970-0075
Mailing address
1412 S ST STE 100, SACRAMENTO, CA 95811-7155
(916) 616-8561
(916) 970-0075
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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