Douglas Dean Davis II
Community Health Worker in Van Nuys, CA. Individual provider (NPI-1).
NPI number1407552706
StatusActive
Last updated in NPPESJul 1, 2023
Details
- NPI
- 1407552706
- Entity type
- Individual (NPI-1)
- Name
- Douglas Dean Davis II
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 7, 2023
- Certification date
- Jul 1, 2023
- Last updated
- Jul 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | CA | Yes |
Practice location
16650 Sherman WayVan Nuys, CA 91406-3782
Phone 818-901-4836
Mailing address
16536 Ballinger StNorth Hills, CA 91343-1806
Phone 818-293-9596
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