Individual
MR. AMU XENAPHON DARYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGPCNP, CNS
Contact information
Practice address
6 TARMAN DR, CLOVERDALE, CA 95425-3932
(707) 894-4229
Mailing address
5885 EL CAJON BLVD UNIT 110, SAN DIEGO, CA 92115-3755
(213) 248-1556
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95035288
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95035288
CA
364SA2100X
Acute Care Clinical Nurse Specialist
12345
CA
Other
Enumeration date
12/04/2024
Last updated
07/16/2026
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