MEDICARE: DAISY MICHELLE SUAREZ LCSW

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	1041S0200X	School Social Worker	LCSW125816	CA

General Provider Information

NPI Number	:	1568971976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISY MICHELLE SUAREZ LCSW

Provider Business Mailing Address
First Line	:	1535 N BROADWAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-2099
Country	:	US
Telephone Number	:	760-291-4027
Fax Number	:	760-489-4129

Provider Business Practice Location Address
First Line	:	1535 N BROADWAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-2099
Country	:	US
Telephone Number	:	760-291-4027
Fax Number	:	760-489-4129

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

Provider Enumeration Date	:	09/28/2017
Last Update Date	:	12/05/2024

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