Provider Demographics
NPI:1063445716
Name:DARRINGTON, THERESA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIE
Last Name:DARRINGTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:STOLWORTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4091 RIVERSIDE DR
Mailing Address - Street 2:STE 117
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-6502
Mailing Address - Country:US
Mailing Address - Phone:909-287-3423
Mailing Address - Fax:909-902-0894
Practice Address - Street 1:4091 RIVERSIDE DR
Practice Address - Street 2:STE 117
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-6502
Practice Address - Country:US
Practice Address - Phone:909-287-3423
Practice Address - Fax:909-902-0894
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16075103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA129277OtherMEDICARE PTAN
CAOPL160750Medicare PIN
CACA129277OtherMEDICARE PTAN