Provider Demographics
NPI:1588364756
Name:DAY, NICOLE ASHLEY (LCSW, PPSC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ASHLEY
Last Name:DAY
Suffix:
Gender:F
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14104 WINGED FOOT CIR
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-6664
Mailing Address - Country:US
Mailing Address - Phone:760-717-9901
Mailing Address - Fax:
Practice Address - Street 1:28751 COLE GRADE RD
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6575
Practice Address - Country:US
Practice Address - Phone:760-749-0464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA937051041C0700X
1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool