Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARYANNA STAERK, MBA, LDN
Deactivated Sole ProprietorMARYANNA STAERK, MBA, LDN is a Registered Dietitian healthcare provider located in LAKE FOREST, California. NPI 1174759104 is deactivated in the NPPES registry. Verify at CMS.
Registered Dietitian · LAKE FOREST, CA
This NPI has been deactivated.
The record was deactivated on April 21, 2021.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1174759104
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 4, 2009 (11.879452054795 yrs)
- Last Updated
- Sep 12, 2025
- Deactivated
- Apr 21, 2021
- License
-
DN008520 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
24531 VIA TONADALAKE FOREST, CA, 926302027Browse CA providers · Browse ZIP 92630
- Phone
- 9496909132
- Primary Specialty
-
Registered Dietitian
133V00000X
Other Registered Dietitian Providers in LAKE FOREST, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. KRISTINE M SCHWARTZ | RD | 1043469794 |
| JIN KUO | RDN | 1780087833 |
| TIFFANY GUNNEMANN | — | 1992298426 |
| MRS. CERISSA ROMAN | MPH, RDN | 1275120883 |
| TATIANA KARINA NEWMAN | RDN | 1184394306 |
| JOLENE WANG | — | 1558249409 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.