Davinesha Marie Sally
Registered Nurse in Los Angeles, CA. Individual provider (NPI-1).
NPI number1962044206
StatusActive
Last updated in NPPESMay 28, 2024
Details
- NPI
- 1962044206
- Entity type
- Individual (NPI-1)
- Name
- Davinesha Marie Sally
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 8, 2019
- Certification date
- May 28, 2024
- Last updated
- May 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 95376792 | CA | Yes |
| 163WP0808X | Registered Nurse, Psych/Mental Health | 95376792 | CA | |
| 167G00000X | Licensed Psychiatric Technician | 41383 | CA | |
| 225400000X | Rehabilitation Practitioner | 41383 | CA |
Practice location
840 N Avenue 66Los Angeles, CA 90042-1508
Phone 626-395-7100
Mailing address
840 N Avenue 66Los Angeles, CA 90042-1508
Phone 626-395-7100
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