Provider Demographics
NPI:1508536582
Name:AVILES, CHARYSSE MARIE DILAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHARYSSE MARIE
Middle Name:DILAY
Last Name:AVILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-7517
Mailing Address - Fax:619-532-9501
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-5555
Practice Address - Country:US
Practice Address - Phone:619-532-7517
Practice Address - Fax:619-532-9501
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1016271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical