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General NPI Number Information
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NPI Number | 1154781631
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Entity Type | Individual
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Provider Name | HARVEY SPARKS
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Gender | Male
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Dates
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Enumeration Date | 02/26/2016
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 4725 HOEN AVE STE B
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City | SANTA ROSA
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State | CA
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Zip | 95405-9405
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Country | US
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Telephone | 707-542-1154
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Fax | 707-542-4818
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Provider Business Mailing Address
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Address Line | 750 N COMMONS DR STE 200
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City | AURORA
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State | IL
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Zip | 60504-8025
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Country | US
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Telephone | 630-303-5380
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Fax | 630-303-5385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA7400
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License Number State | IL
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