Healthcare Provider Details

I. General information

NPI: 1598498925
Provider Name (Legal Business Name): DARIO GABRIEL SHIELDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

IV. Provider business mailing address

2107 CANYON VIEW DR
NEWMAN CA
95360-1469
US

V. Phone/Fax

Practice location:
  • Phone: 408-842-7138
  • Fax:
Mailing address:
  • Phone: 831-905-7548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: