Provider Demographics
NPI:1053130401
Name:YOWELL, DARA CRISTINE
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:CRISTINE
Last Name:YOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:CRISTINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 AMALFI LOOP APT 149
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-8017
Mailing Address - Country:US
Mailing Address - Phone:719-439-3231
Mailing Address - Fax:
Practice Address - Street 1:425 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1936
Practice Address - Country:US
Practice Address - Phone:408-343-9442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator