Jacqueline Stark Nursing PC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

JACQUELINE STARK NURSING PC

Doing business as

Bronze Star Medical Staff Specialists

Practice address

2951 Bluebell Ave
Brea, CA 92821-4702

Phone

(714) 640-4460

Fax

(888) 607-0923

NPI assigned

Jul 30, 2015

Last updated

Jul 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Stark, CRNA

Title

President/Owner

Phone

(714) 640-4460

Specialties & licenses 1

Addresses

Other names 1

• Bronze Star Medical Staff Specialists Doing business as

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1811373988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HOLLAND",
            "address_2": "SUITE 101",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182566",
            "telephone_number": "949-588-2190",
            "fax_number": "949-588-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 BLUEBELL AVE",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214702",
            "telephone_number": "714-640-4460",
            "fax_number": "888-607-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE STARK NURSING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "714-640-4460",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bronze Star Medical Staff Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Certified Registered Nurse Anesthetist in Brea, CA
• Providers in Brea, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.