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NPI Code Detail

MEDICARE: KARINA VIDA DAVIS

MEDICARE: KARINA VIDA 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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1689301665
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARINA VIDA DAVIS
Provider Business Mailing Address
First Line : 380 ENCINAL #200
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060
Country : US
Telephone Number : 831-469-1700
Fax Number :
Provider Business Practice Location Address
First Line : 7200 BANCROFT AVE STE 133
Second Line :
City : OAKLAND
State : CA
Zip : 94605-2480
Country : US
Telephone Number : 510-553-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2022
Last Update Date : 03/31/2026

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Directions to “ KARINA VIDA DAVIS ” Practice Location

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