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General NPI Number Information
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NPI Number | 1699436055
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Entity Type | Individual
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Provider Name | DARIN DRAKE DICKINSON
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Gender | Male
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 13200 CROSSROADS PKWY N BLDG 300
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91746-3459
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Country | US
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Telephone | 562-841-1491
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 KINGSTON RD
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City | PLACENTIA
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State | CA
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Zip | 92870-2521
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Country | US
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Telephone | 909-921-2476
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | E2301735
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License Number State | CA
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