Provider Demographics
NPI:1689973349
Name:STARR, JESSIE ANNE (MA, ATC)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:ANNE
Last Name:STARR
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-4300
Mailing Address - Country:US
Mailing Address - Phone:650-543-3739
Mailing Address - Fax:650-543-3707
Practice Address - Street 1:1000 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-4300
Practice Address - Country:US
Practice Address - Phone:650-543-3739
Practice Address - Fax:650-543-3707
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer