Healthcare Provider Details

I. General information

NPI: 1053240002
Provider Name (Legal Business Name): ERNESTINA OWUSU DARKO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11403 RAMONA RD
LOMA LINDA CA
92354-4183
US

IV. Provider business mailing address

11403 RAMONA RD
LOMA LINDA CA
92354-4183
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax: 909-894-7983
Mailing address:
  • Phone: 909-825-7084
  • Fax: 909-894-7983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: