Jacob Davis
Counselor, Addiction (Substance Use Disorder) in Los Angeles, CA. Individual provider (NPI-1).
NPI number1982147401
StatusActive
Last updated in NPPESDec 1, 2016
Details
- NPI
- 1982147401
- Entity type
- Individual (NPI-1)
- Name
- Jacob Davis
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 1, 2016
- Last updated
- Dec 1, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | R1237171116 | CA | Yes |
Practice location
900 Avila StLos Angeles, CA 90012-4287
Phone 213-229-0985
Mailing address
900 Avila StLos Angeles, CA 90012-4287
Phone 213-229-0985
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