Provider Demographics
NPI:1104038942
Name:DAY, CAROL (MSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:DAY-DRUMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:SDDMHS, 707 BROADWAY
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101
Mailing Address - Country:US
Mailing Address - Phone:858-410-1067
Mailing Address - Fax:619-533-6007
Practice Address - Street 1:SDDMHS, 707 BROADWAY
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:858-410-1067
Practice Address - Fax:619-533-6007
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS118711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical