William Stark

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3556 S 5600 W
West Valley City, UT 84120-2815

Phone

(888) 922-2843

Fax

(855) 568-2494

NPI assigned

Sep 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Willow Stark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1801564760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 408",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858",
            "telephone_number": "310-856-0800",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 S 5600 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841202815",
            "telephone_number": "888-922-2843",
            "fax_number": "855-568-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLOW",
            "last_name": "STARK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Behavior Technician in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Behavior Technician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.