Healthcare Provider Details

I. General information

NPI: 1669281556
Provider Name (Legal Business Name): JOY CHIDINMA DAVIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY CHIDINMA OGBONNA

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 ARNOLD DR STE 110
MARTINEZ CA
94553-4189
US

IV. Provider business mailing address

105 LAUREL KNOLL DR
MARTINEZ CA
94553-3928
US

V. Phone/Fax

Practice location:
  • Phone: 408-504-5156
  • Fax:
Mailing address:
  • Phone: 408-504-5156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95208504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: