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NPI Code Detail

MEDICARE: AMANDA DAVIS

MEDICARE: AMANDA DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1023175700
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA DAVIS
Provider Business Mailing Address
First Line : 1362 ARNOLD AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95110-1403
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 251 JACKSON AVE
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94061-1630
Country : US
Telephone Number : 650-368-2383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/08/2007

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Directions to “ AMANDA DAVIS ” Practice Location

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