Healthcare Provider Details

I. General information

NPI: 1033510201
Provider Name (Legal Business Name): DARRIN OLIVER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 S DWIGHT AVE
COMPTON CA
90220-4446
US

IV. Provider business mailing address

1005 S DWIGHT AVE
COMPTON CA
90220-4446
US

V. Phone/Fax

Practice location:
  • Phone: 310-991-2339
  • Fax:
Mailing address:
  • Phone: 310-638-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW70435
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: