MEDICARE: KAMERON 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1891656120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMERON DAVIS

Provider Business Mailing Address
First Line	:	8100 WYOMING BLVD NE # 406M-4
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-1946
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 WASHINGTON ST NE STE A
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-1846
Country	:	US
Telephone Number	:	505-828-3837
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	02/12/2026

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Directions to “ KAMERON DAVIS ” Practice Location

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