Provider Demographics
NPI:1770353278
Name:DAY, STACY (HEALTH COACH)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33005 CHRISTINA DR
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-1009
Mailing Address - Country:US
Mailing Address - Phone:949-295-1154
Mailing Address - Fax:
Practice Address - Street 1:33005 CHRISTINA DR
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-1009
Practice Address - Country:US
Practice Address - Phone:949-295-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach