Willie Anthoney Davis Jr.
Technician, Attendant Care Provider in Ramona, CA. Individual provider (NPI-1).
NPI number1265121750
StatusActive
Last updated in NPPESMay 2, 2023
Details
- NPI
- 1265121750
- Entity type
- Individual (NPI-1)
- Name
- Willie Anthoney Davis Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 2, 2023
- Certification date
- May 2, 2023
- Last updated
- May 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
23430 Calistoga PlRamona, CA 92065-4309
Phone 209-769-5243
Mailing address
23430 Calistoga PlRamona, CA 92065-4309
Phone 209-769-5243
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