Individual provider · NPI-1

Lisa Carol Davis

Registered Nurse, Psych/Mental Health, Adult · Colton, CA

NPI number1750692380
StatusActive
Last updated in NPPESJun 29, 2010

Details

NPI
1750692380
Entity type
Individual (NPI-1)
Name
Lisa Carol Davis
Sex
Female
Sole proprietor
No
Enumeration date
Jun 29, 2010
Last updated
Jun 29, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WP0809X Registered Nurse, Psych/Mental Health, Adult650954CAYes

Practice location

400 N Pepper Ave
Colton, CA 92324-1801

Phone 909-580-3144 · Fax 909-580-2165

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801

Phone 909-580-3144 · Fax 909-580-2165

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