Provider Demographics
NPI:1952959348
Name:DEMOUCHET, DARRILYN BILLEW (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DARRILYN
Middle Name:BILLEW
Last Name:DEMOUCHET
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 N MILLIKEN AVE STE 1007
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-5083
Mailing Address - Country:US
Mailing Address - Phone:909-997-5333
Mailing Address - Fax:
Practice Address - Street 1:11800 CENTRAL AVE STE 125
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-7202
Practice Address - Country:US
Practice Address - Phone:909-997-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016037363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health