Healthcare Provider Details

I. General information

NPI: 1649091679
Provider Name (Legal Business Name): SPROUT ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 GOLD MEADOW WAY STE 160
GOLD RIVER CA
95670-6365
US

IV. Provider business mailing address

2355 GOLD MEADOW WAY STE 160
GOLD RIVER CA
95670-6365
US

V. Phone/Fax

Practice location:
  • Phone: 279-218-9207
  • Fax: 279-218-9523
Mailing address:
  • Phone: 279-218-9207
  • Fax: 279-218-9523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: ALINA MUKHOPADHYAY
Title or Position: CEO
Credential:
Phone: 279-218-9207