Provider Demographics
NPI:1477174647
Name:STARKEY, SHELBY NICOLE
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:NICOLE
Last Name:STARKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 GALLERY DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7918
Mailing Address - Country:US
Mailing Address - Phone:765-228-7850
Mailing Address - Fax:
Practice Address - Street 1:1260 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-7326
Practice Address - Country:US
Practice Address - Phone:765-228-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician