Active NPI
Jerry H Sparks, LCSW
- Clinical Social Worker
- Woodland Hills, CA
National Provider Identifier
1821295775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS11751
- Practice address
- 5601 De Soto Ave
Woodland Hills, CA 91367-6701 - Phone
- (818) 719-2000
- Fax
- (626) 405-6768
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS11751 | CA | Primary |
Addresses
Primary practice location
5601 De Soto Ave
Woodland Hills, CA 91367-6701
Mailing address
393 E Walnut St
3Rd Floor - PHR Systems
Pasadena, CA 91188-0001
Phone (626) 405-7914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS11751 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821295775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 E WALNUT ST",
"address_2": "3RD FLOOR - PHR SYSTEMS",
"city": "PASADENA",
"state": "CA",
"postal_code": "911880001",
"telephone_number": "626-405-7914",
"fax_number": "626-405-6768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 DE SOTO AVE",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913676701",
"telephone_number": "818-719-2000",
"fax_number": "626-405-6768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "JERRY",
"middle_name": "H",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS11751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.