Healthcare Provider Details

I. General information

NPI: 1548496268
Provider Name (Legal Business Name): DARLA JEAN DOWNS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 06/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E FESLER ST
SANTA MARIA CA
93454-4404
US

IV. Provider business mailing address

1120 E FOSTER RD APT. B
SANTA MARIA CA
93455-6429
US

V. Phone/Fax

Practice location:
  • Phone: 805-922-6597
  • Fax:
Mailing address:
  • Phone: 805-934-0597
  • Fax: 805-934-0597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberVN77076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: