Nichole Katrina Stark, LPN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

284320 Issued in CA

Practice address

2640 Breslauer Way
Redding, CA 96001-4246

Phone

(530) 225-5200

NPI assigned

Oct 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1225313463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40020 PUMICE DR",
            "city": "CASSEL",
            "state": "CA",
            "postal_code": "96016",
            "telephone_number": "262-960-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 BRESLAUER WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960014246",
            "telephone_number": "530-225-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "NICHOLE",
        "middle_name": "KATRINA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "314285-31",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "284320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislaus County
• Robert Stanley
• Don V. Stanton, M.D.
• John Thomas Stapp
• Laura Elizabeth Stapp
• Cindy Deeann Starkey
• Starling House, Licensed Clinical Social Worker, Inc
• Isaiah Joshua Starr
• Mark R Starr
• Cheston Stearns

• Licensed Vocational Nurse in Redding, CA
• Providers in Redding, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.