JACQUELINE STARK (NPI# 1396742284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396742284 |
| Entity Type | Individual |
| Full Name | JACQUELINE STARK |
| Credential | CRNA |
| Practice Address |
3350 W Ball Rd Anesthesia Department Anaheim CA 92804-3710 |
| Mailing Address |
210 N Tustin Ave Santa Ana CA 92705-3807 |
| Practice Telephone | 7148276700 |
| Mailing Telephone | 7143471010 |
| Mailing Fax Number | 7146471245 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | R148323 | MD | Other Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 3393 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 000831101 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811052319 | Jacqueline A Stark | Nurse Practitioner | 12500 Aurora Dr, Pleasant Prairie, WI 53158-1227 | 2006-12-26 |
| Street Address |
3350 W BALL RD ANESTHESIA DEPARTMENT |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92804-3710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922370303 | Shankar Sundaram M.d., Inc. | Anesthesiology | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2012-02-01 |
| 1033440987 | Blue Wave Anesthesia Group, Inc. | Anesthesiology | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2010-01-15 |
| 1235469685 | Oc Path Medical Group | Pathology | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2010-01-07 |
| 1891933404 | Ali A Ali Md Inc | Pathology | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2009-02-04 |
| 1578747606 | Premier Emergency Physicians of California, A Medical Corporation | Emergency Medicine | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2007-12-26 |
| 1598948382 | Twila Reid Emergency Physicians | Emergency Medicine | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2007-12-14 |
| 1285727057 | Anaheim General Hospital Ltd | Psychiatric Unit | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2006-10-02 |
| 1316956691 | Hiba Hussain | Anesthesiology | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2006-08-05 |
| 1114941812 | Ralph E Conner IIi | Emergency Medicine | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2006-07-26 |
| 1558383935 | Mohammad Rajper | Emergency Medicine | 3350 W Ball Rd, Anaheim, CA 92804-3710 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811517261 | Crown Care Hospice Inc | Hospice Care, Community Based | 10568 Magnolia Ave., Suite106, Stanton, CA 92804 | 2020-04-24 |
| 1154971646 | Leita Pawline Lawrene | Technician | 900 S Beach Blvd # 132, Anaheim, CA 92804 | 2019-09-17 |
| 1942767611 | Yasmen Abuyousef | Behavior Technician | 714 W Commonweath Ave, Suite C, Fullerton, CA 92804 | 2019-02-28 |
| 1225501224 | Brandon Pourazima | Physician Assistant | 631 S Brookhurst St Ste 213b, Anaheim, CA 92804 | 2019-01-02 |
| 1043782576 | Origins Home Health Care Inc. | Home Health | 137 1/2 S So Knott, Anaheim, CA 92804 | 2018-12-21 |
| 1346762150 | Inhee Shinn | Acupuncturist | 1717 W. Ball Road., Anaheim, CA 92804 | 2017-07-13 |
| 1689122459 | Jayanthi Ravikumar Md Inc | Physical Medicine & Rehabilitation | 3356 W Ball Road, #216, Anaheim, CA 92804 | 2016-09-21 |
| 1215307954 | Tuan Manh Hoang | Dentist | 1317 S. Courtright Street, Anaheim, CA 92804 | 2015-10-06 |
| 1598101602 | Optimal Sleep Center | Clinical Medical Laboratory | 3340 West Ball Road Suite B, Anaheim, CA 92804 | 2013-05-15 |
| 1376885673 | Michelle Lananh Dang | Pharmacist | 1913 W. Elm Pl, Anaheim, CA 92804 | 2013-03-25 |
| Find all providers in zip 92804 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568828754 | Sanah Qureshi | Nurse Anesthetist, Certified Registered | 2546 E Strong Pl, Anaheim, CA 92806 | 2016-01-05 |
| 1346501400 | Susan Elizabeth Yudt | Nurse Anesthetist, Certified Registered | 728 S Olive St, Anaheim, CA 92805-4741 | 2012-06-06 |
| 1164924247 | Laura Koh | Nurse Anesthetist, Certified Registered | 3440 E La Palma Ave, Anaheim, CA 92806-2020 | 2018-03-05 |
| 1396264271 | Jan Katherine Albert | Nurse Anesthetist, Certified Registered | 3440 E La Palma Ave, Anaheim, CA 92806-2020 | 2017-09-12 |
| 1871940510 | Evan Scheier | Nurse Anesthetist, Certified Registered | 3440 E La Palma Ave, Anaheim, CA 92806-2020 | 2016-05-23 |
| 1508247677 | Paula Marie Vencilao Arcala | Nurse Anesthetist, Certified Registered | 3440 E La Palma Ave, Anaheim, CA 92806-2020 | 2015-06-15 |
| 1699925032 | Becky L Ly | Nurse Anesthetist, Certified Registered | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2008-09-23 |
| 1437350329 | Michael P Churchin | Nurse Anesthetist, Certified Registered | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2007-05-30 |
| 1881710028 | Lee Michaels | Nurse Anesthetist, Certified Registered | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2007-03-21 |
| 1326196270 | Tracy L Ouzounian | Nurse Anesthetist, Certified Registered | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2007-01-08 |
| Find all providers in ANAHEIM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.