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1265616973
DARRELL L. BROADDUS
LA MESA, CA
NPI
1265616973
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY 20101)
Enumeration Date
2007-12-18
Last Update Date
2007-12-18
Business Address
-- DARRELL L. BROADDUS Ph.D.
8029 LA MESA BLVD SUITE A
LA MESA, CA 91941-6434
Phone number: 619-668-0600
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Mailing Address
-- DARRELL L. BROADDUS Ph.D.
6461 ASPEN GARDENS WAY
CITRUS HEIGHTS, CA 95621-5626
Phone number: 916-705-7388
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