Healthcare Provider Details

I. General information

NPI: 1740292739
Provider Name (Legal Business Name): REBECCA J. DAY PA - FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W H ST 380
OAKDALE CA
95361-3588
US

IV. Provider business mailing address

PO BOX 2224
OAKDALE CA
95361-5224
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-0314
  • Fax:
Mailing address:
  • Phone: 209-499-4852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA13692
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350628
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: