Individual
LINDA STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27701 MURRIETA RD, SPACE 186, MENIFEE, CA 92586-6301
(951) 309-1485
Mailing address
27701 MURRIETA RD, SPACE 186, MENIFEE, CA 92586-6301
(951) 309-1485
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
MTRN32610
MT
163WC0400X
Case Management Registered Nurse
2006029133
MO
163WC0400X
Case Management Registered Nurse
Primary
572824
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
231366
NC
Other
Enumeration date
03/19/2014
Last updated
03/25/2014
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