Provider Demographics
NPI:1679097844
Name:DARROW, MARJORY JILL (CADC -II)
Entity Type:Individual
Prefix:
First Name:MARJORY
Middle Name:JILL
Last Name:DARROW
Suffix:
Gender:F
Credentials:CADC -II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12125 SHALE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-8880
Mailing Address - Country:US
Mailing Address - Phone:530-885-1917
Mailing Address - Fax:
Practice Address - Street 1:12125 SHALE RIDGE LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-8880
Practice Address - Country:US
Practice Address - Phone:530-885-1917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054260419101YA0400X
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)