Provider Demographics
NPI:1932786233
Name:DAILY, ALISHA C (CMT)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:C
Last Name:DAILY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6763 ALAMO CT
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-5876
Mailing Address - Country:US
Mailing Address - Phone:619-829-4803
Mailing Address - Fax:
Practice Address - Street 1:11300 SORRENTO VALLEY RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1329
Practice Address - Country:US
Practice Address - Phone:858-519-7867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty