Healthcare Provider Details

I. General information

NPI: 1992317390
Provider Name (Legal Business Name): SARA PATRICE STARK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 09/21/2023
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8307 BRIMHALL RD STE 1706
BAKERSFIELD CA
93312-4343
US

IV. Provider business mailing address

1301 AQUARIUS CT APT 15
BAKERSFIELD CA
93309-3800
US

V. Phone/Fax

Practice location:
  • Phone: 661-467-1477
  • Fax: 661-616-9303
Mailing address:
  • Phone: 661-444-0094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95015171
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95015171
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015171
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95015171
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: