MEDICARE: BEVERLY DALEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	9377	CA

General Provider Information

NPI Number	:	1336561620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY DALEY

Provider Business Mailing Address
First Line	:	5230 BELLINGHAM AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-2666
Country	:	US
Telephone Number	:	818-766-4769
Fax Number	:

Provider Business Practice Location Address
First Line	:	5230 BELLINGHAM AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-2666
Country	:	US
Telephone Number	:	818-766-4769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2014
Last Update Date	:	01/06/2014

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Directions to “ BEVERLY DALEY ” Practice Location

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