Provider Demographics
NPI:1346657582
Name:DR DEARMOND
Entity Type:Organization
Organization Name:DR DEARMOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ISABELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DE ARMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:707-599-7626
Mailing Address - Street 1:13120 POMO LANE
Mailing Address - Street 2:
Mailing Address - City:MENDOCINO
Mailing Address - State:CA
Mailing Address - Zip Code:95460
Mailing Address - Country:US
Mailing Address - Phone:707-937-2590
Mailing Address - Fax:
Practice Address - Street 1:13120 POMO LN
Practice Address - Street 2:
Practice Address - City:MENDOCINO
Practice Address - State:CA
Practice Address - Zip Code:95460-9602
Practice Address - Country:US
Practice Address - Phone:707-937-2590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25905103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty