Healthcare Provider Details

I. General information

NPI: 1811741911
Provider Name (Legal Business Name): SIVAN DAVIE WATKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HOWE AVE # 400-B
SACRAMENTO CA
95825-4731
US

IV. Provider business mailing address

650 HOWE AVE # 400-B
SACRAMENTO CA
95825-4731
US

V. Phone/Fax

Practice location:
  • Phone: 916-441-0123
  • Fax:
Mailing address:
  • Phone: 916-441-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: