Search › California › 1041C0700X
Dianna Stark, LCSW
NPI 1922303999 · on the registry since 2011 · sole proprietor
Practice
- Address
- 32242 Paseo Adelanto
Suite D5
San Juan Capistrano, CA 92675 - Phone
- (917) 637-0912
- Organisation at this address
- South Shores Detox Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
- Licence states on file
- NY, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2016-06-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California