Provider Demographics
NPI:1346260478
Name:STARK, DARCINA ANN (ATC)
Entity Type:Individual
Prefix:MS
First Name:DARCINA
Middle Name:ANN
Last Name:STARK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 E CREEKSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-3157
Mailing Address - Country:US
Mailing Address - Phone:916-709-9395
Mailing Address - Fax:
Practice Address - Street 1:4315 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2727
Practice Address - Country:US
Practice Address - Phone:916-733-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer