MEDICARE: DARRELL DWIGHT ALLEN APCC

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
1	101Y00000X	Counselor
2	171M00000X	Case Manager/Care Coordinator
3	101YP2500X	Professional Counselor	APCC9095	CA

General Provider Information

NPI Number	:	1306214804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL DWIGHT ALLEN APCC

Provider Business Mailing Address
First Line	:	3451 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3242
Country	:	US
Telephone Number	:	323-335-4175
Fax Number	:

Provider Business Practice Location Address
First Line	:	3451 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3242
Country	:	US
Telephone Number	:	559-492-8327
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	06/20/2025

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