Provider Demographics
NPI:1982273769
Name:WHITNEY, DAISY BIANEY
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:BIANEY
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAISY
Other - Middle Name:BIANEY
Other - Last Name:GRACIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1130 4TH ST APT 315
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4063
Mailing Address - Country:US
Mailing Address - Phone:603-391-6873
Mailing Address - Fax:
Practice Address - Street 1:2656 EL PRADO WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0304
Practice Address - Country:US
Practice Address - Phone:916-800-2872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician