NPIMap

Individual provider Active NPI

Keith Ian Star

  • Marriage & Family Therapist
  • Tarzana, CA
National Provider Identifier
1174836951
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC28743 Issued in CA
Practice address
18646 Oxnard St
Tarzana, CA 91356-1411
Phone
(818) 996-1051
NPI assigned
Jul 21, 2010
Last updated
Jul 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC28743 CA Primary

Addresses

Primary practice location

18646 Oxnard St
Tarzana, CA 91356-1411

Mailing address

18646 Oxnard St
Tarzana, CA 91356-1411
Phone (818) 996-1051

Other names 1

  • Keith Star Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111002373 CA Practitioner - Marriage and Family Therapist 0446688345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC28743CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Treatment Centers, Inc. CurrentSince Aug 4, 2025 Accepting new patients
Los Angeles County Department of Public Health Current Accepting new patients
Tarzana Treatment Centers, Inc. Current Accepting new patients

Locations

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

Interoperability endpoints

  • Direct secure messaging: keithstar-tarzanatc@lacsapc.netsmartdirect.net

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tarzana Treatment Centers IncTarzana, CA, CCN 054148 Hospital Other Jan 8, 1996
Tarzana Treatment Centers IncLancaster, CA, CCN 921920 Federally qualified health center Corporate Director Jan 31, 2005
Tarzana Treatment Centers IncTarzana, CA, CCN 921948 Federally qualified health center Corporate Director Jan 31, 2005
Tarzana Treatment Centers IncPalmdale, CA, CCN 921922 Federally qualified health center Corporate Director Jan 31, 2005
Tarzana Treatment Centers IncNorthridge, CA, CCN 921921 Federally qualified health center Corporate Director Jan 31, 2005
Tarzana Treatment Centers IncReseda, CA, CCN 921947 Federally qualified health center Corporate Director Jan 31, 2005
Tarzana Treatment Centers IncLong Beach, CA, CCN A01020 Federally qualified health center Operational/Managerial Control Jan 31, 2005
Tarzana Treatment Centers IncReseda, CA, CCN A11012 Federally qualified health center Corporate Director Jan 31, 2005
Tarzana Treatment Centers IncPalmdale, CA, CCN A01971 Federally qualified health center Corporate Director Jan 31, 2005

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1174836951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18646 OXNARD ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561411",
            "telephone_number": "818-996-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18646 OXNARD ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561411",
            "telephone_number": "818-996-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAR",
        "first_name": "KEITH",
        "middle_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC28743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEITH",
            "last_name": "STAR",
            "credential": "LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.