Provider Demographics
NPI:1205056181
Name:DARCY, MARIA U (PHD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:U
Last Name:DARCY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 JAMBOREE RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3024
Mailing Address - Country:US
Mailing Address - Phone:949-698-0590
Mailing Address - Fax:407-408-6843
Practice Address - Street 1:4425 JAMBOREE RD
Practice Address - Street 2:SUITE 270
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3024
Practice Address - Country:US
Practice Address - Phone:949-698-0590
Practice Address - Fax:407-408-6843
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7140103TC1900X
CA26246103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9004OtherBLUECROSSBLUESHIELD P #