Provider Demographics
NPI:1063589281
Name:DARBYSHIRE, SUZANNE GAIL (COUNSELOR)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:GAIL
Last Name:DARBYSHIRE
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:260 POWDER CT
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-5958
Mailing Address - Country:US
Mailing Address - Phone:707-435-9911
Mailing Address - Fax:707-435-0704
Practice Address - Street 1:1143 MISSOURI ST.
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5958
Practice Address - Country:US
Practice Address - Phone:707-435-9911
Practice Address - Fax:707-435-0704
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4416101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4416OtherCAS