| California Sprout Mc 1 Llc | |
|
611 Gateway Blvd Ste 120 South San Francisco CA 94080-7066 | |
| (833) 458-0386 | |
| Not Available |
| Full Name | California Sprout Mc 1 Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 611 Gateway Blvd Ste 120, South San Francisco, California |
| Authorized Official Name and Position | Yury Yakubchyk (OWNER) |
| Authorized Official Contact | 7862108200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| California Sprout Mc 1 Llc 19 W 24th St Fl 4 New York NY 10010-3239 Ph: () - | California Sprout Mc 1 Llc 611 Gateway Blvd Ste 120 South San Francisco CA 94080-7066 Ph: (833) 458-0386 |
| NPI Number | 1902434178 |
|---|---|
| Provider Enumeration Date | 04/01/2020 |
| Last Update Date | 07/28/2025 |
| Certification Date | 07/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902434178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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