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NPI Code Detail

MEDICARE: DONYA DARVISH

MEDICARE: DONYA DARVISH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194505123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONYA DARVISH
Provider Business Mailing Address
First Line : 3917 CORBIN AVE
Second Line :
City : TARZANA
State : CA
Zip : 91356-5618
Country : US
Telephone Number : 323-590-3748
Fax Number :
Provider Business Practice Location Address
First Line : 2625 TOWNSGATE RD STE 102
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91361-5726
Country : US
Telephone Number : 805-413-3009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2023
Last Update Date : 10/05/2023

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Directions to “ DONYA DARVISH ” Practice Location

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