Organization
CALIFORNIA SPROUT MC 1 LLC
Active
Other names
Tilly, Sprout Therapy, Elemy
Organization subpart
No
Provider details
NPI number
Authorized official
YURY YAKUBCHYK SR. (OWNER)
(786) 210-8200
Entity
Organization
Contact information
Practice address
611 GATEWAY BLVD STE 120, SOUTH SAN FRANCISCO, CA 94080-7066
(833) 458-0386
Mailing address
19 W 24TH ST FL 4, NEW YORK, NY 10010-3239
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/01/2020
Last updated
07/28/2025
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