Basic Information
| Provider Information | |||||||||
| NPI: | 1255443362 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAVES | ||||||||
| FirstName: | DAYANA | ||||||||
| MiddleName: | GIZZENA | ||||||||
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| Credential: | ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 828 FRANKLIN ST | ||||||||
| Address2: | #711 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153757591 | ||||||||
| FaxNumber: | 6506209549 | ||||||||
| Practice Location | |||||||||
| Address1: | 957 B INDUSTRIAL RD | ||||||||
| Address2: | |||||||||
| City: | SAN CARLOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004963019 | ||||||||
| FaxNumber: | 6506209549 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | ACSW17386 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.