Timothy A. Stark

Key facts

NPI

1457500670

Entity type

Individual (NPI type 1)

Primary specialty

Marriage & Family Therapist 106H00000X

Practice address

84-275 Makaha Valley Rd
Waianae, HI 96792-2130

Phone

(808) 927-4084

NPI assigned

Sep 11, 2008

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2008.

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1457500670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84-275 MAKAHA VALLEY RD",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967922130",
            "telephone_number": "808-927-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84-275 MAKAHA VALLEY RD",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967922130",
            "telephone_number": "808-927-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "TIMOTHY",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

• Jennifer Souza, FNP-C
• Star F Souza
• Zabrina H. Spencer
• St. Francis Medical Center - Waianae Dialysis
• Karen A Stanlaw, M.D.
• State of Hawaii Department of Health
• William Xavier Staub, LAC
• Steadfast Housing Development Corp
• Alexandra Steppe, M.S., R.D.
• Steps for Inedependence, Inc.

All providers in Waianae, HI · Marriage & Family Therapist in Hawaii