Healthcare Provider Details
I. General information
NPI: 1467314278
Provider Name (Legal Business Name): NEUROSPROUT ACADEMY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41593 WINCHESTER RD STE 200
TEMECULA CA
92590-4857
US
IV. Provider business mailing address
41593 WINCHESTER RD STE 200
TEMECULA CA
92590-4857
US
V. Phone/Fax
- Phone: 626-808-6870
- Fax:
- Phone: 626-808-6870
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERYL
HOANG-ALI
Title or Position: FOUNDER/CFO
Credential: BCBA
Phone: 626-808-6870