Provider Demographics
NPI:1508204975
Name:PLUMMER, STARR BOBBIE-ANN
Entity Type:Individual
Prefix:
First Name:STARR
Middle Name:BOBBIE-ANN
Last Name:PLUMMER
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 1:2118 GRANT AVE
Mailing Address - Street 2:6
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3634
Mailing Address - Country:US
Mailing Address - Phone:310-402-4969
Mailing Address - Fax:
Practice Address - Street 1:2118 GRANT AVE
Practice Address - Street 2:6
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3634
Practice Address - Country:US
Practice Address - Phone:310-402-4969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist