Healthcare Provider Details
I. General information
NPI: 1851962104
Provider Name (Legal Business Name): DACARA SEWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4930 NAPLES ST
SAN DIEGO CA
92110-3820
US
IV. Provider business mailing address
4930 NAPLES ST
SAN DIEGO CA
92110-3820
US
V. Phone/Fax
- Phone: 619-276-1176
- Fax:
- Phone: 619-276-1176
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: