MEDICARE: KELSEA S DAY TRAWEEK

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	171M00000X	Case Manager/Care Coordinator
4	225400000X	Rehabilitation Practitioner
5	390200000X	Student in an Organized Health Care Education/Training Program
6	106H00000X	Marriage & Family Therapist	134939	CA

General Provider Information

NPI Number	:	1437446275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEA S DAY TRAWEEK

Provider Business Mailing Address
First Line	:	18225 HALE AVE STE 200
Second Line	:
City	:	MORGAN HILL
State	:	CA
Zip	:	95037-3547
Country	:	US
Telephone Number	:	408-465-8280
Fax Number	:

Provider Business Practice Location Address
First Line	:	4612 ROOSEVELT AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95820-4520
Country	:	US
Telephone Number	:	916-379-5876
Fax Number	:

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

Provider Enumeration Date	:	06/30/2011
Last Update Date	:	10/12/2022

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Directions to “ KELSEA S DAY TRAWEEK ” Practice Location

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