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General NPI Number Information
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NPI Number | 1194265199
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Entity Type | Individual
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Provider Name | DARYL SPARKS PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 23141 MOULTON PKWY STE 207
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1204
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Country | US
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Telephone | 877-414-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 23141 MOULTON PKWY STE 207
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1204
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 94024833
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License Number State | CA
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