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General NPI Number Information
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NPI Number | 1164547154
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Entity Type | Organization
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Legal Business Name | DAVIS COUNSELING MEDIATION & ADVOCACY CENTER
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2050 LYNDELL TERR SUITE 130
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City | DAVIS
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State | CA
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Zip | 95616-6205
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Country | US
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Telephone | 530-759-1929
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Fax | 530-759-1929
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Provider Business Mailing Address
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Address Line | 2050 LYNDELL TERR SUITE 130
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City | DAVIS
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State | CA
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Zip | 95616-6205
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Country | US
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Telephone | 530-759-1929
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Fax | 530-759-1929
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST OFFIC
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Name | KATHRYN A SPECTOR
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Credential | LMFT
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Telephone | 530-759-1929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY9009
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC42035
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License Number State | CA
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