Doctor Name: | TAMARA ROSE STARK |
NPI Number: | 1053436527 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | |
Business Practice Address: | 550 W Vista Way Ste 407 Vista, CA - 920835714 |
Business Phone Number: | 7607581092 |
Business Fax Number: | |
Mailing Address: | 760 Loma Alta Ter, VISTA |
State: | CA |
Postal Code: | 920833330 |
Phone Number: | 7609414815 |
Fax Number: | |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |