Provider Demographics
NPI:1619373677
Name:ALDER, DARRELL II
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:
Last Name:ALDER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7236 GREENHAVEN DR APT 74
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3538
Mailing Address - Country:US
Mailing Address - Phone:916-606-5330
Mailing Address - Fax:
Practice Address - Street 1:7236 GREENHAVEN DR APT 74
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3538
Practice Address - Country:US
Practice Address - Phone:916-606-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor