Active NPI
Jennifer L. Stark, M. A.
- Marriage & Family Therapist
- Los Banos, CA
National Provider Identifier
1619006541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC41011
- Practice address
- 1435 W I St
Los Banos, CA 93635-4546 - Phone
- (209) 509-5272
- Fax
- (209) 826-3663
- NPI assigned
- Mar 5, 2007
- 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 | MFC41011 | CA | Primary |
Addresses
Primary practice location
1435 W I St
Los Banos, CA 93635-4546
Mailing address
PO Box 2438
Los Banos, CA 93635-2438
Phone (209) 509-5272
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC41011 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1619006541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2438",
"city": "LOS BANOS",
"state": "CA",
"postal_code": "936352438",
"telephone_number": "209-509-5272",
"fax_number": "209-826-3663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1435 W I ST",
"city": "LOS BANOS",
"state": "CA",
"postal_code": "936354546",
"telephone_number": "209-509-5272",
"fax_number": "209-826-3663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "JENNIFER",
"middle_name": "L.",
"credential": "M. A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC41011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Banos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.