Provider Demographics
NPI:1902967987
Name:DINSMORE, DARRELL BRIAN
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:BRIAN
Last Name:DINSMORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W 16TH ST
Mailing Address - Street 2:#4
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928
Mailing Address - Country:US
Mailing Address - Phone:530-571-6393
Mailing Address - Fax:
Practice Address - Street 1:592 RIO LINDO AVENUE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-891-2775
Practice Address - Fax:530-895-6547
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor