Healthcare Provider Details

I. General information

NPI: 1023128196
Provider Name (Legal Business Name): JEFF STEPHEN DALY PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 S MELROSE DR
VISTA CA
92081-6627
US

IV. Provider business mailing address

325 S MELROSE DR
VISTA CA
92081-6627
US

V. Phone/Fax

Practice location:
  • Phone: 760-936-0014
  • Fax:
Mailing address:
  • Phone: 760-936-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY19886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: