Provider Demographics
NPI:1053991414
Name:DARLING, TANNER E (BD)
Entity type:Individual
Prefix:
First Name:TANNER
Middle Name:E
Last Name:DARLING
Suffix:
Gender:M
Credentials:BD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18726 S WESTERN AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3858
Mailing Address - Country:US
Mailing Address - Phone:310-856-0800
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:3255 OLD CONEJO RD STE 202
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-2153
Practice Address - Country:US
Practice Address - Phone:805-254-2494
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician