Provider Demographics
NPI:1831540756
Name:DARG, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DARG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 N H ST STE F
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-8137
Mailing Address - Country:US
Mailing Address - Phone:805-322-8014
Mailing Address - Fax:
Practice Address - Street 1:1133 N H ST STE F
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-8137
Practice Address - Country:US
Practice Address - Phone:805-322-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)