Provider Demographics
NPI:1568509081
Name:STARLEY, DENICE (DO)
Entity Type:Individual
Prefix:DR
First Name:DENICE
Middle Name:
Last Name:STARLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CARMEN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7729
Mailing Address - Country:US
Mailing Address - Phone:805-928-7361
Mailing Address - Fax:805-332-3750
Practice Address - Street 1:1130 COFFEE RD
Practice Address - Street 2:BLDG 2B
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4228
Practice Address - Country:US
Practice Address - Phone:209-284-0729
Practice Address - Fax:209-342-6634
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13342081P2900X
CA20A112032081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104760OtherMEDICARE PTAN
NVV104760OtherMEDICARE PTAN