SPARK PSYCHEDELIC THERAPY
NPI 1760093454
Psychiatry & Neurology - Psychiatry in San Pedro, CA

Q: What is Spark Physician Assistant Services, Inc.'s specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since August 14, 2020

3031 S DENISON AVE, SAN PEDRO, CA 90731(323) 379-3611(786) 629-6142 Get Directions Write a Review

NPPES record last updated: September 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 8, 2020, Aug 14, 2020 (2 updates tracked since 2020).

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About Spark Psychedelic Therapy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPARK PSYCHEDELIC THERAPY (NPI 1760093454) is a healthcare organization registered as a psychiatry in San Pedro, California and active in the NPI registry since August 2020. The organization lists Christina Ribao, Owner, as its authorized official.

NPPES Registry Identity

NPI1760093454

Entity TypeOrganization

Primary Taxonomy2084P0800X

Legal Business NameSPARK PHYSICIAN ASSISTANT SERVICES, INC.

Location Address3031 S DENISON AVESan Pedro, CA 90731-6703

Mailing Address3031 S Denison AveSan Pedro, CA 90731-6703 · (786) 599-0360

Phone(323) 379-3611

Fax(786) 629-6142

Organization SubpartNo

Authorized OfficialChristina RibaoOwner · (323) 379-3611

Enumeration DateAugust 14, 2020

Last NPPES UpdateSeptember 8, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 8, 2020

✔ NPI 1760093454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

3031 S DENISON AVE, San Pedro, CA 90731

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Other Names 2

Doing Business AsSpark Psychedelic Therapy

Doing Business AsSpark Therapeutics

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACK EVERETT DOWNHILL JR. MD

Psychiatry & Neurology (Psychiatry)

3031 S DENISON AVE
SAN PEDRO, CA 90731

Los Angeles County (323) 379-3611

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spark Physician Assistant Services, Inc.'s NPI number?

The NPI number for Spark Physician Assistant Services, Inc. is 1760093454. It was assigned to this organization in the NPPES registry on August 14, 2020. The provider is doing business as Spark Psychedelic Therapy and Spark Therapeutics.

Where is Spark Physician Assistant Services, Inc. located?

Spark Physician Assistant Services, Inc. is located at 3031 S Denison Ave, San Pedro, CA 90731. The listed phone number is (323) 379-3611.

What is Spark Physician Assistant Services, Inc.'s specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

When was this NPI record last updated?

The NPPES record for Spark Physician Assistant Services, Inc. was last updated on September 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.