Provider Demographics
NPI:1982388096
Name:KISSINGER, STARLA SARAH (MSW, ASW)
Entity Type:Individual
Prefix:
First Name:STARLA
Middle Name:SARAH
Last Name:KISSINGER
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 HARTNELL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-5070
Mailing Address - Country:US
Mailing Address - Phone:530-410-7515
Mailing Address - Fax:
Practice Address - Street 1:2030 HARTNELL AVE STE D
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-5070
Practice Address - Country:US
Practice Address - Phone:530-410-7515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker