Stella Detarsio-Park

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ND463 Issued in CA

Practice address

1 Rio Vista Ave
Oakland, CA 94611-5320

Phone

(510) 277-7428

NPI assigned

Apr 27, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1649657826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 BLANDING AVE",
            "address_2": "C340",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011579",
            "telephone_number": "510-277-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIO VISTA AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115320",
            "telephone_number": "510-277-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETARSIO-PARK",
        "first_name": "STELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "ND463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjev Desilva
• Allison Bree Desmond, LCSW
• Timothy Ambrose Desmond, MA
• Jane Dessing, PSYD
• Shunnae A Destephano, M.S., CCC-SLP
• Benjamin Deters
• Jesse Detorres, CO
• Robert Allen Deuchar
• Robin Ann Deutsch, PH.D.
• Caroline S Devany, NP

• General Practice Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.