1538282231 NPI number — MS. BONNIE ROSE DALY L.M.F.T.

Table of content: MS. BONNIE ROSE DALY L.M.F.T. (NPI 1538282231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538282231 NPI number — MS. BONNIE ROSE DALY L.M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DALY
Provider First Name:
BONNIE
Provider Middle Name:
ROSE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.M.F.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DALY
Provider Other First Name:
BONNIE
Provider Other Middle Name:
ROSE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1538282231
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
964 5TH AVE
Provider Second Line Business Mailing Address:
SUITE 435
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92101-6102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-544-1435
Provider Business Mailing Address Fax Number:
619-544-1439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
964 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 435
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92101-6102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-544-1435
Provider Business Practice Location Address Fax Number:
619-544-1439
Provider Enumeration Date:
04/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 22840 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 163WP0809X , with the licence number: RN 104963 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)