Provider Demographics
NPI:1972702033
Name:MABERY, DARLA JO (DO)
Entity Type:Individual
Prefix:DR
First Name:DARLA
Middle Name:JO
Last Name:MABERY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1158 CIRBY WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4478
Mailing Address - Country:US
Mailing Address - Phone:916-774-7348
Mailing Address - Fax:916-774-1556
Practice Address - Street 1:1158 CIRBY WAY
Practice Address - Street 2:SUITE B
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4478
Practice Address - Country:US
Practice Address - Phone:916-774-7348
Practice Address - Fax:916-774-1556
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5894208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice