=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780600650
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DARLENE MARIE LEMMO MFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 11/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2055 KELLOGG AVE # 210
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92879-3111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-898-7133
-----------------------------------------------------
Fax | 951-898-7401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1911 WILLIAMS DR 200
-----------------------------------------------------
City | OXNARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93036-2612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-981-4225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC41721
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------