Provider Demographics
NPI:1063693968
Name:PLANT, DAROLYN UNDERWOOD (NP)
Entity type:Individual
Prefix:
First Name:DAROLYN
Middle Name:UNDERWOOD
Last Name:PLANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DAROLYN
Other - Middle Name:SUE
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:405 W 5TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4522
Mailing Address - Country:US
Mailing Address - Phone:714-834-2125
Mailing Address - Fax:
Practice Address - Street 1:23228 MADERO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-454-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP17831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health