Healthcare Provider Details

I. General information

NPI: 1114474350
Provider Name (Legal Business Name): SHANNA LEE DARLING PMHNP-BC, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21535 HAWTHORNE BLVD STE 200
TORRANCE CA
90503-6612
US

IV. Provider business mailing address

21535 HAWTHORNE BLVD STE 200
TORRANCE CA
90503-6612
US

V. Phone/Fax

Practice location:
  • Phone: 424-284-2440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95004917
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number780007
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95004917
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: