Provider Demographics
NPI:1881320166
Name:DARICK, DAVID THOMAS (LMFT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:THOMAS
Last Name:DARICK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 LOS MORROS WAY UNIT 83
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-3738
Mailing Address - Country:US
Mailing Address - Phone:619-356-0756
Mailing Address - Fax:
Practice Address - Street 1:5045 LOS MORROS WAY UNIT 83
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-3738
Practice Address - Country:US
Practice Address - Phone:619-356-0756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC11708101YM0800X
CA94028471390200000X
CALMFT147702106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program