Provider Demographics
NPI:1396900932
Name:DAY, ABDUL-HAKIM JEREMIAH
Entity type:Individual
Prefix:MR
First Name:ABDUL-HAKIM
Middle Name:JEREMIAH
Last Name:DAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JEREMIAH
Other - Middle Name:DAY
Other - Last Name:EUSTICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13970 ESTATE WAY
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7438
Mailing Address - Country:US
Mailing Address - Phone:760-952-2654
Mailing Address - Fax:
Practice Address - Street 1:14360 SAINT ANDREWS DR
Practice Address - Street 2:11
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4341
Practice Address - Country:US
Practice Address - Phone:760-243-5417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor