Healthcare Provider Details

I. General information

NPI: 1053130401
Provider Name (Legal Business Name): DARA CRISTINE YOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARA CRISTINE JOHNSON MS, APCC

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 GLEN CANYON RD
SCOTTS VALLEY CA
95066-4923
US

IV. Provider business mailing address

500 AMALFI LOOP APT 149
MILPITAS CA
95035-8017
US

V. Phone/Fax

Practice location:
  • Phone: 831-227-2691
  • Fax:
Mailing address:
  • Phone: 719-439-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: