Healthcare Provider Details
I. General information
NPI: 1205121761
Provider Name (Legal Business Name): SUNNY DAYS EARLY CHILDHOOD DEVELOPMENTAL SERVICES OF CA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2011
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8775 AERO DR SUITE 238
SAN DIEGO CA
92123-1792
US
IV. Provider business mailing address
8775 AERO DR SUITE 238
SAN DIEGO CA
92123-1792
US
V. Phone/Fax
- Phone: 805-571-0300
- Fax: 858-571-0050
- Phone: 805-571-0300
- Fax: 858-571-0050
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
CAMERON
MICHAEL
STONE
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 858-571-0030