Healthcare Provider Details

I. General information

NPI: 1578721585
Provider Name (Legal Business Name): DARLENE K. WHEELER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N CHINA LAKE BLVD
RIDGECREST CA
93555-3131
US

IV. Provider business mailing address

1111 N CHINA LAKE BLVD
RIDGECREST CA
93555-3131
US

V. Phone/Fax

Practice location:
  • Phone: 760-499-3855
  • Fax: 760-499-3870
Mailing address:
  • Phone: 760-499-3855
  • Fax: 760-499-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: