Healthcare Provider Details

I. General information

NPI: 1083547541
Provider Name (Legal Business Name): DARLENE VANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 W ASHLAN AVE
CLOVIS CA
93612-5627
US

IV. Provider business mailing address

454 HELM AVE
CLOVIS CA
93612-0713
US

V. Phone/Fax

Practice location:
  • Phone: 559-473-1770
  • Fax:
Mailing address:
  • Phone: 559-776-4286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: