Provider Demographics
NPI:1083765291
Name:DAVIS, DARLENE ANNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:ANNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 ALHAMBRA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-6543
Mailing Address - Country:US
Mailing Address - Phone:916-248-2436
Mailing Address - Fax:916-780-1058
Practice Address - Street 1:1430 ALHAMBRA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6543
Practice Address - Country:US
Practice Address - Phone:916-248-2436
Practice Address - Fax:916-780-1058
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CAMFC40875101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health