Provider Demographics
NPI:1588959969
Name:AYOTTE, DARLENE (CMA,CPT1)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:AYOTTE
Suffix:
Gender:F
Credentials:CMA,CPT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5185 CERULEAN WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-1842
Mailing Address - Country:US
Mailing Address - Phone:760-529-2902
Mailing Address - Fax:
Practice Address - Street 1:5185 CERULEAN WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-1842
Practice Address - Country:US
Practice Address - Phone:760-529-2902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPT43766OtherSTATE LICENSE CPT1
CANCCT656717OtherCERTIFIED MEDICAL ASSISTANT