Healthcare Provider Details

I. General information

NPI: 1871883975
Provider Name (Legal Business Name): ELIZABETH MARIE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N HANDY ST
ORANGE CA
92867-4434
US

IV. Provider business mailing address

1401 N HANDY ST
ORANGE CA
92867-4434
US

V. Phone/Fax

Practice location:
  • Phone: 714-628-4080
  • Fax:
Mailing address:
  • Phone: 714-628-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: