Brenda G Vaccaro, MA, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29151 Issued in CA

Practice address

1412 S St Ste 100
Sacramento, CA 95811-7155

Phone

(916) 616-8561

Fax

(916) 914-2074

NPI assigned

Oct 14, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spark Center for Psychology, Inc.

  dba Spark Center for Psychology

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sacramento, CA
  • NPI 1770114662

  Clinical

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184934911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 S ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958117155",
            "telephone_number": "916-616-8561",
            "fax_number": "916-914-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 S ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958117155",
            "telephone_number": "916-616-8561",
            "fax_number": "916-914-2074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8080 Madison Ave",
            "address_2": "Suite 200 D",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956283759",
            "country_code": "US",
            "telephone_number": "916-616-8561",
            "fax_number": "916-534-7753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "BRENDA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MA, PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB34264",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chisom Ephraim Uzoukwu
• Zeynep B Uzumcu, MD
• V S N F Inc (University Post-Acute Rehab)
• VA Hospital Mather
• Sabrina Ahn Vaa, NP
• Kadra Beverly Vaccaro, PA-C
• Brad Thomas Vachon, DO
• Cara Lammers Vachon, DO
• Michaela Vachuska
• Milana Natalie Vachuska

• Clinical Psychologist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.