Healthcare Provider Details

I. General information

NPI: 1376985473
Provider Name (Legal Business Name): DARLENE TOWNES PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12636 HIGH BLUFF DR STE 400
SAN DIEGO CA
92130-2071
US

IV. Provider business mailing address

PO BOX 506774
SAN DIEGO CA
92150-6774
US

V. Phone/Fax

Practice location:
  • Phone: 858-500-2434
  • Fax: 858-815-6646
Mailing address:
  • Phone: 619-427-4667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY31615
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY31615
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY31615
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: