Basic Information
| Provider Information | |||||||||
| NPI: | 1093372617 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OBREGON | ||||||||
| FirstName: | DARLENE | ||||||||
| MiddleName: | ANGELICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3120 FREEBOARD DR STE 120 | ||||||||
| Address2: | |||||||||
| City: | WEST SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956915039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303517975 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3120 FREEBOARD DR STE 120 | ||||||||
| Address2: | |||||||||
| City: | WEST SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956915039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303517975 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2019 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 128854 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | 128854 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.