MEDICARE: CYNTHIA ANN STARKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	131629	CA

General Provider Information

NPI Number	:	1790979854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA ANN STARKS

Provider Business Mailing Address
First Line	:	2433 65TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-1906
Country	:	US
Telephone Number	:	510-232-0874
Fax Number	:

Provider Business Practice Location Address
First Line	:	2433 65TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-1906
Country	:	US
Telephone Number	:	510-232-0874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	08/31/2007

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Directions to “ CYNTHIA ANN STARKS ” Practice Location

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