Provider Demographics
NPI:1386071447
Name:HIRSH, DARRA (PHD)
Entity type:Individual
Prefix:DR
First Name:DARRA
Middle Name:
Last Name:HIRSH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 SHAW AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3839
Mailing Address - Country:US
Mailing Address - Phone:559-712-8500
Mailing Address - Fax:559-712-8505
Practice Address - Street 1:334 SHAW AVE STE 100
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612
Practice Address - Country:US
Practice Address - Phone:559-712-8500
Practice Address - Fax:559-712-8505
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16504103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical