Individual
DARRELL L. BROADDUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8029 LA MESA BLVD, SUITE A, LA MESA, CA 91941-6434
(619) 668-0600
(619) 466-2662
Mailing address
6461 ASPEN GARDENS WAY, CITRUS HEIGHTS, CA 95621-5626
(916) 705-7388
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 20101
CA
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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