Provider Demographics
NPI:1972842821
Name:STARR, ISAIAH JOSHUA
Entity type:Individual
Prefix:
First Name:ISAIAH
Middle Name:JOSHUA
Last Name:STARR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 KNOLLCREST DR STE 101
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0181
Mailing Address - Country:US
Mailing Address - Phone:530-392-4399
Mailing Address - Fax:
Practice Address - Street 1:415 KNOLLCREST DR STE 101
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0181
Practice Address - Country:US
Practice Address - Phone:530-392-4399
Practice Address - Fax:530-392-4399
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18522101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health