Healthcare Provider Details

I. General information

NPI: 1275494759
Provider Name (Legal Business Name): DAVINDER DARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1646 S COURT ST
VISALIA CA
93277-4962
US

IV. Provider business mailing address

10779 N HAMPSHIRE DR
FRESNO CA
93730-0621
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-8890
  • Fax:
Mailing address:
  • Phone: 559-618-0042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95037632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: