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General NPI Number Information
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NPI Number | 1962136341
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Entity Type | Individual
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Provider Name | JENNA DARWICHE
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 11/03/2024
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Provider Practice Location Address
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Address Line | 1300 E CYPRESS ST BLDG A
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City | SANTA MARIA
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State | CA
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Zip | 93454-4728
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Country | US
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Telephone | 805-250-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 25880 TIMBER TRL
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-4108
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Country | US
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Telephone | 313-909-3174
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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