Provider Demographics
NPI:1144463696
Name:STARR, STAR ETOILE (MS)
Entity type:Individual
Prefix:MR
First Name:STAR
Middle Name:ETOILE
Last Name:STARR
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 ARLINGTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-1955
Mailing Address - Country:US
Mailing Address - Phone:951-352-3943
Mailing Address - Fax:951-637-1577
Practice Address - Street 1:6711 ARLINGTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-1955
Practice Address - Country:US
Practice Address - Phone:951-352-3943
Practice Address - Fax:951-637-1577
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACDLU4022620103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst