Individual
ANDREA SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6400
Mailing address
755 AZALEA DR, ROCKVILLE, MD 20850-2016
(330) 367-9044
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
12/23/2022
Last updated
02/16/2026
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