Provider Demographics
NPI:1689128282
Name:DAYTON, PATIENCE (LCSW)
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:DAYTON
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:PO BOX 246491
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-6491
Mailing Address - Country:US
Mailing Address - Phone:916-598-5648
Mailing Address - Fax:
Practice Address - Street 1:3112 O ST STE 11
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6579
Practice Address - Country:US
Practice Address - Phone:916-598-5648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2021-02-26
Deactivation Date:2018-05-30
Deactivation Code:
Reactivation Date:2021-02-26
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA989401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program