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General NPI Number Information
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NPI Number | 1265814255
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Entity Type | Organization
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Legal Business Name | STARKENBURG PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1505 15TH ST STE A
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City | LOS ALAMOS
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State | NM
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Zip | 87544-3000
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Country | US
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Telephone | 505-500-5894
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Fax | 505-557-1140
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Provider Business Mailing Address
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Address Line | 1505 15TH ST STE A
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City | LOS ALAMOS
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State | NM
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Zip | 87544-3000
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Country | US
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Telephone | 505-500-5894
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Fax | 505-557-1140
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANE ARLENE STARKENBURG
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Credential | PSY.D., MSCP
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Telephone | 505-500-5894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 1134
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License Number State | NM
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