Individual
ANGELA RENEE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3978 SORRENTO VALLEY BLVD, SUITE 100, SAN DIEGO, CA 92121
(858) 428-0222
Mailing address
5005 TEXAS ST STE 203, SAN DIEGO, CA 92108-3723
(619) 692-0727
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/18/2017
Last updated
12/21/2017
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