Healthcare Provider Details

I. General information

NPI: 1164874327
Provider Name (Legal Business Name): DARBY CHILDRESS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 W OAK AVE
VISALIA CA
93291-6036
US

IV. Provider business mailing address

35414 OLIVERA DR
WOODLAKE CA
93286-9728
US

V. Phone/Fax

Practice location:
  • Phone: 559-280-3904
  • Fax:
Mailing address:
  • Phone: 559-280-3904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number93742
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number93742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: