Healthcare Provider Details

I. General information

NPI: 1548175631
Provider Name (Legal Business Name): DR. GENA YUVETTE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 1/2 W 25TH ST
LOS ANGELES CA
90018-1918
US

IV. Provider business mailing address

8306 WILSHIRE BLVD # 485
BEVERLY HILLS CA
90211-2304
US

V. Phone/Fax

Practice location:
  • Phone: 310-295-4366
  • Fax:
Mailing address:
  • Phone: 310-295-4366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: