Healthcare Provider Details

I. General information

NPI: 1265309264
Provider Name (Legal Business Name): DR. DAVINA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 SEAPORT CT STE 101
REDWOOD CITY CA
94063-2782
US

IV. Provider business mailing address

499 SEAPORT CT STE 101
REDWOOD CITY CA
94063-2782
US

V. Phone/Fax

Practice location:
  • Phone: 650-366-4299
  • Fax:
Mailing address:
  • Phone: 650-366-4299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVINA DICK
Title or Position: OWNER, LEAD ACUPUNCTURIST
Credential: DAOM, L.AC.
Phone: 650-366-4299