Provider Demographics
NPI:1710559315
Name:MATTHEWS, DARLETHA (MSN, FNP-BC, RN-BC)
Entity Type:Individual
Prefix:
First Name:DARLETHA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSN, FNP-BC, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17360 BROOKHURST STREET
Mailing Address - Street 2:ATTN: NETWORK MANAGEMENT
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3720
Mailing Address - Country:US
Mailing Address - Phone:866-276-3627
Mailing Address - Fax:
Practice Address - Street 1:17360 BROOKHURST STREET
Practice Address - Street 2:ATTN: NETWORK MANAGEMENT
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3720
Practice Address - Country:US
Practice Address - Phone:866-276-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016774363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily