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General NPI Number Information
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NPI Number | 1124818083
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Entity Type | Individual
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Provider Name | DAVID BENJAMIN DAVIS III RN, MSN, MHS, FNP
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Gender | Male
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 1080 EMELINE AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95060-1966
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Country | US
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Telephone | 831-345-3266
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Fax |
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Provider Business Mailing Address
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Address Line | 2956 ROSSMORE CT
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City | SAN JOSE
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State | CA
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Zip | 95148-3524
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Country | US
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Telephone | 650-743-2611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95036726
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 552048
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License Number State | CA
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