Individual
DARLA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
(805) 781-4145
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
513025
CA
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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