Provider Demographics
NPI:1346958550
Name:DALEY WELLNESS GROUP, PSYCHOLOGICAL & SPIRITUAL HEALTH, P.C.
Entity Type:Organization
Organization Name:DALEY WELLNESS GROUP, PSYCHOLOGICAL & SPIRITUAL HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:415-967-2505
Mailing Address - Street 1:PO BOX 581905
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-0033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2801 COFFEE RD STE A1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-1756
Practice Address - Country:US
Practice Address - Phone:415-967-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty