SPRK Psychological Services Incorporated

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SPRK PSYCHOLOGICAL SERVICES INCORPORATED

Practice address

324 N Lincoln St
Burbank, CA 91506-2112

Phone

(714) 552-0371

NPI assigned

Jul 8, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Edward Scott Stella, MD

Title

Owner

Phone

(805) 723-2873

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1801529599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1182",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913411182",
            "telephone_number": "818-612-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N LINCOLN ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062112",
            "telephone_number": "714-552-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRK PSYCHOLOGICAL SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "STELLA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-723-2873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Burbank, CA
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• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.