Basic Information
| Provider Information | |||||||||
| NPI: | 1629662572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANKLIN | ||||||||
| FirstName: | DARIEN | ||||||||
| MiddleName: | JADAIAH LOVE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3451 WINTER WAY | ||||||||
| Address2: | |||||||||
| City: | MADERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936375957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597065518 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1915 HOWARD RD STE B&C | ||||||||
| Address2: | |||||||||
| City: | MADERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936375163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593302211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2021 | ||||||||
| LastUpdateDate: | 02/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y4466444 | CA | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 106S00000X | Y4466444 | CA | Y |
No ID Information.