Healthcare Provider Details

I. General information

NPI: 1013113877
Provider Name (Legal Business Name): RICHARD MICHAEL DAY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 CEDAR ST A
PARADISE CA
95969-4602
US

IV. Provider business mailing address

805 CEDAR ST A
PARADISE CA
95969-4602
US

V. Phone/Fax

Practice location:
  • Phone: 530-877-5845
  • Fax: 530-877-3976
Mailing address:
  • Phone: 530-877-5845
  • Fax: 530-877-3976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS23114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: