Active NPI
Barbara Pearl Stark, PSY.D.
- Clinical Psychologist
- Santa Monica, CA
National Provider Identifier
1104154350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY12764
- Practice address
- 1247 10TH St
4
Santa Monica, CA 90401-1944 - Phone
- (310) 394-1095
- Fax
- (310) 394-8930
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY12764 | CA | Primary |
Addresses
Primary practice location
1247 10TH St
4
Santa Monica, CA 90401-1944
Mailing address
825 Wilshire Blvd
710
Santa Monica, CA 90401-1809
Phone (805) 452-6479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12764 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259539200000",
"number": "1104154350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 WILSHIRE BLVD",
"address_2": "710",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011809",
"telephone_number": "805-452-6479",
"fax_number": "310-394-8930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1247 10TH ST",
"address_2": "4",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011944",
"telephone_number": "310-394-1095",
"fax_number": "310-394-8930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "BARBARA",
"middle_name": "PEARL",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-30",
"last_updated": "2009-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY12764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.