Julissa Sparks, LPCC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7942 Issued in CA

Practice address

149 Pasadena Ave Ste a
South Pasadena, CA 91030-3351

Phone

(323) 274-3065

NPI assigned

Feb 9, 2017

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Hillsides

  • Adolescent and Children Mental Health Clinic/Center
  • South Pasadena, CA
  • NPI 1902920176
  NPD
• Leomar Health Group Inc

  dba Pacific Health Group

  • Psychiatry Physician
  • Carlsbad, CA
  • NPI 1912688656

  Professional

  NPD
• Hillsides

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1508983776
  NPD (past)

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1437697539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 COLORADO BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411744",
            "telephone_number": "323-543-2800",
            "fax_number": "323-978-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 PASADENA AVE STE A",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303351",
            "telephone_number": "323-274-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "JULISSA",
        "credential": "LPCC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "2634",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "7942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Pasadena General Dentistry Inc
• South Pasadena Optometric Group, Inc.
• South Pasadena Pediatrics, a Professional Corporation (South Pasadena Pediatrics)
• South Pasadena Rehabilitation Center, LLC (MIssion Grove Healthcare & Wellness Centre)
• Southern California Neurosurgical Associates, Inc
• Daniel Fred Spector, PH.D.
• Vincent Frank Spero, DDS
• Catherine Spicer, LMFT
• St. Jude Radiology Medical Group, Inc.
• Lisa Staab Shadburn, PSY.D.

• Professional Counselor in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.