Individual provider Active NPI

Theresa Marie Darrington, PH.D.

  • Psychologist
  • Chino, CA
National Provider Identifier
1063445716
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY16075 Issued in CA
Practice address
4091 Riverside Dr
Ste 117
Chino, CA 91710-6502
Phone
(909) 287-3423
Fax
(909) 902-0894
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY16075 CA Primary

Addresses

Primary practice location

4091 Riverside Dr
Ste 117
Chino, CA 91710-6502

Mailing address

4091 Riverside Dr
Ste 117
Chino, CA 91710-6502
Phone (909) 287-3423

Other identifiers 1

IdentifierTypeStateIssuer
CA129277OtherCAMEDICARE PTAN

Other names 1

  • Theresa Marie Stolworthy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000614 CA Practitioner - Clinical Psychologist 8527235316 Practice locations: Chino, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4091 Riverside Dr
Suite 117
Chino, CA 91710-6502
Phone (909) 287-3423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16075CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maureen Burney PastSince Sep 14, 2011 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1063445716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4091 RIVERSIDE DR",
            "address_2": "STE 117",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917106502",
            "telephone_number": "909-287-3423",
            "fax_number": "909-902-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4091 RIVERSIDE DR",
            "address_2": "STE 117",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917106502",
            "telephone_number": "909-287-3423",
            "fax_number": "909-902-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARRINGTON",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA129277",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "STOLWORTHY",
            "middle_name": "MARIE",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.