Ronald Joseph Stark, RAS #S0906221308

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

RAS #S0906221308 Issued in CA

Practice address

4283 El Cajon Blvd Ste 115
San Diego, CA 92105-1289

Phone

(619) 521-1743

Fax

(619) 521-1896

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1891826434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4283 EL CAJON BLVD STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051289",
            "telephone_number": "619-521-1743",
            "fax_number": "619-521-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4283 EL CAJON BLVD STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051289",
            "telephone_number": "619-521-1743",
            "fax_number": "619-521-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "RAS #S0906221308",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "RAS #S0906221308",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RAS #S0906221308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danette Stark
• Dena Stark
• Erica Dawn Stark, L.AC.
• Michael J Stark
• Phoebe Catherine Stark
• Serenity Natalia Stark
• Taylor Stark
• Victoria Stark
• Alina Starker, PA-C
• Elena Starker

• Case Manager/Care Coordinator in San Diego, CA
• Providers in San Diego, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.