Healthcare Provider Details

I. General information

NPI: 1134738123
Provider Name (Legal Business Name): HOLLY DARNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S B ST
OXNARD CA
93030-5916
US

IV. Provider business mailing address

1890 W HILLCREST DR APT 368
NEWBURY PARK CA
91320-2344
US

V. Phone/Fax

Practice location:
  • Phone: 805-525-6616
  • Fax:
Mailing address:
  • Phone: 202-441-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138819
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: