Active NPI
Darrelyn Kay Dutcher-Wolf, PT
- Physical Therapist
- Camarillo, CA
National Provider Identifier
1194847574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 14765
- Practice address
- 450 Rosewood Ave Ste 105
Camarillo, CA 93010-5914 - Phone
- (805) 389-4781
- Fax
- (805) 389-4725
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 14765 | CA | Primary |
Addresses
Primary practice location
450 Rosewood Ave Ste 105
Camarillo, CA 93010-5914
Mailing address
167 Geneive St
Camarillo, CA 93010-7817
Phone (805) 479-3357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 14765 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1194847574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 GENEIVE ST",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930107817",
"telephone_number": "805-479-3357",
"fax_number": "805-987-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 ROSEWOOD AVE STE 105",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930105914",
"telephone_number": "805-389-4781",
"fax_number": "805-389-4725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTCHER-WOLF",
"first_name": "DARRELYN",
"middle_name": "KAY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 14765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.