Healthcare Provider Details

I. General information

NPI: 1841230778
Provider Name (Legal Business Name): HELEN DAVIS PHD, MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11770 BERNARDO PLAZA COURT SUITE 370
SAN DIEGO CA
92128-2426
US

IV. Provider business mailing address

PO BOX 609001
SAN DIEGO CA
92160-9001
US

V. Phone/Fax

Practice location:
  • Phone: 858-673-3360
  • Fax: 858-592-0884
Mailing address:
  • Phone: 619-528-4600
  • Fax: 619-528-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC23765
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: