| Star Of Ca Llc | |
|
4880 Market St Suite 220 Ventura CA 93003-7783 | |
| (805) 644-7827 | |
| (877) 644-7545 |
| Full Name | Star Of Ca Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4880 Market St, Ventura, California |
| Authorized Official Name and Position | Douglas Raymond Moes (PRESIDENT) |
| Authorized Official Contact | 8056447827 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Of Ca Llc 4880 Market St Ventura CA 93003-7783 Ph: (805) 644-7827 | Star Of Ca Llc 4880 Market St Suite 220 Ventura CA 93003-7783 Ph: (805) 644-7827 |
| NPI Number | 1669613972 |
|---|---|
| Provider Enumeration Date | 03/16/2009 |
| Last Update Date | 02/27/2020 |
| Certification Date | 02/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669613972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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