Provider Demographics
NPI:1063646420
Name:DARMODY, KATHREN RUTH (RN)
Entity Type:Individual
Prefix:
First Name:KATHREN
Middle Name:RUTH
Last Name:DARMODY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27600 MEDFORD WAY
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2118
Mailing Address - Country:US
Mailing Address - Phone:858-716-7210
Mailing Address - Fax:
Practice Address - Street 1:27600 MEDFORD WAY
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-2118
Practice Address - Country:US
Practice Address - Phone:858-716-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA602266163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse