Active NPI
Dana Fogel Stark, LMFT
- Marriage & Family Therapist
- Reseda, CA
National Provider Identifier
1497817043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC39754
- Practice address
- 19231 Victory Blvd Ste 110
Reseda, CA 91335-6321 - Phone
- (818) 708-4500
- Fax
- (818) 654-1956
- NPI assigned
- Dec 13, 2006
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC39754 | CA | Primary |
Addresses
Primary practice location
19231 Victory Blvd Ste 110
Reseda, CA 91335-6321
Mailing address
19231 Victory Blvd Ste 110
Reseda, CA 91335-6321
Phone (818) 708-4500
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 |
|---|---|---|---|
| MFC39754 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497817043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19231 VICTORY BLVD STE 110",
"city": "RESEDA",
"state": "CA",
"postal_code": "913356321",
"telephone_number": "818-708-4500",
"fax_number": "818-654-1956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19231 VICTORY BLVD STE 110",
"city": "RESEDA",
"state": "CA",
"postal_code": "913356321",
"telephone_number": "818-708-4500",
"fax_number": "818-654-1956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "DANA",
"middle_name": "FOGEL",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC39754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Reseda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.