Provider Demographics
NPI:1528243821
Name:ARSENAULT, DARIN (PHD, MFT)
Entity type:Individual
Prefix:
First Name:DARIN
Middle Name:
Last Name:ARSENAULT
Suffix:
Gender:M
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 26802
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92196
Mailing Address - Country:US
Mailing Address - Phone:619-971-5911
Mailing Address - Fax:619-971-5911
Practice Address - Street 1:3111 CAMINO DEL RIO NORTH
Practice Address - Street 2:SUITE 800
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-971-5911
Practice Address - Fax:619-971-5911
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA24775103TH0004X
CA45805106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist