Provider Demographics
NPI:1710124961
Name:DAILEY, JAMIE (RN)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:DAILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5609
Mailing Address - Country:US
Mailing Address - Phone:310-828-7172
Mailing Address - Fax:310-828-8662
Practice Address - Street 1:1801 WILSHIRE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5609
Practice Address - Country:US
Practice Address - Phone:310-828-7172
Practice Address - Fax:310-828-8662
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA697465163WD0400X
IL041.360980163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator