Provider Demographics
NPI:1952440323
Name:DAY, MITZI-ANN M (LICSW)
Entity Type:Individual
Prefix:
First Name:MITZI-ANN
Middle Name:M
Last Name:DAY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MITZI-ANN
Other - Middle Name:M
Other - Last Name:GOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:430 ARGUELLO BLVD APT 204
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2567
Mailing Address - Country:US
Mailing Address - Phone:415-668-8472
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE STE 7M
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-6196
Practice Address - Fax:415-206-6012
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 191341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical