MEDICARE: CAROLYN DAW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	25324	CA

General Provider Information

NPI Number	:	1841123668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN DAW

Provider Business Mailing Address
First Line	:	5155 CLARETON DR STE 100
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-6308
Country	:	US
Telephone Number	:	747-777-0543
Fax Number	:

Provider Business Practice Location Address
First Line	:	5155 CLARETON DR STE 100
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-6308
Country	:	US
Telephone Number	:	747-777-0543
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ CAROLYN DAW ” Practice Location

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