Provider Demographics
NPI:1083305650
Name:DALY, DEBBIE SUZANNE
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:SUZANNE
Last Name:DALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VIA GARCETA
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-1476
Mailing Address - Country:US
Mailing Address - Phone:949-677-3179
Mailing Address - Fax:
Practice Address - Street 1:7 VIA GARCETA
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-1476
Practice Address - Country:US
Practice Address - Phone:949-677-3179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA826610163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse