Deguzman, Darrell Vincecruz

Deguzman, Darrell Vincecruz is an sole proprietor health care provider with primary practice located at 1061 Tierra Del Rey Ste 200 , Chula Vista CA 91910. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Deguzman, Darrell Vincecruz can be contacted via phone (619) 498-5454.

Contact Information

Primary practice address
1061 Tierra Del Rey Ste 200 Chula Vista CA 91910
Phone: (619) 498-5454
Fax: (619) 528-4625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95008025 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X NP95008025 California

Profile Details

NPI number 1245709112
LBN Legal business name Deguzman, Darrell Vincecruz
Credentials PMHNP, FNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2018
Last updated May 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245709112 NPPES
California MEDICAID W416

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