Healthcare Provider Details

I. General information

NPI: 1376092742
Provider Name (Legal Business Name): SPOTLIGHT THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 LOS GATOS SARATOGA RD
LOS GATOS CA
95030-5310
US

IV. Provider business mailing address

3165 MONTECITO MEADOW DR
SANTA ROSA CA
95404-1850
US

V. Phone/Fax

Practice location:
  • Phone: 408-649-7349
  • Fax: 408-628-1302
Mailing address:
  • Phone: 408-649-7349
  • Fax: 408-628-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL M BRANDO
Title or Position: PRESIDENT
Credential:
Phone: 408-649-7349