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NPI Code Detail

MEDICARE: PATRICIA DAVENPORT

MEDICARE: PATRICIA DAVENPORT
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
1101YA0400XAddiction (Substance Use Disorder) CounselorA8444004CA

General Provider Information

NPI Number : 1881015238
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA DAVENPORT
Provider Business Mailing Address
First Line : 1149 WARREN AVE
Second Line :
City : VALLEJO
State : CA
Zip : 94591-7512
Country : US
Telephone Number : 707-552-5295
Fax Number :
Provider Business Practice Location Address
First Line : 1149 WARREN AVE
Second Line :
City : VALLEJO
State : CA
Zip : 94591-7512
Country : US
Telephone Number : 707-552-5295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2014
Last Update Date : 03/15/2026

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Directions to “ PATRICIA DAVENPORT ” Practice Location

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