Provider Demographics
NPI:1649459652
Name:CARPIO-DARSHAY, REBECCA ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANN
Last Name:CARPIO-DARSHAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:CARPIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:17296 SLOVER AVENUE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337
Mailing Address - Country:US
Mailing Address - Phone:909-609-3004
Mailing Address - Fax:909-609-3045
Practice Address - Street 1:17296 SLOVER AVENUE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337
Practice Address - Country:US
Practice Address - Phone:909-609-3004
Practice Address - Fax:909-609-3045
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15350363LX0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0089980Medicaid
CAF40047Medicare UPIN