Provider Demographics
NPI:1912680968
Name:SPOSATO, FRANK SALVATORE
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:SALVATORE
Last Name:SPOSATO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:FRANKIE
Other - Middle Name:BLUE
Other - Last Name:SPOSATO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1602 1/2 S ORANGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-4933
Mailing Address - Country:US
Mailing Address - Phone:310-589-8778
Mailing Address - Fax:
Practice Address - Street 1:11661 SAN VICENTE BLVD STE 606
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5114
Practice Address - Country:US
Practice Address - Phone:323-570-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1262301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical