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General NPI Number Information
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NPI Number | 1225588288
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Entity Type | Individual
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Provider Name | PETRA DAVELAAR ND
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Gender | Female
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 375 HOMEWOOD RD
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City | LOS ANGELES
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State | CA
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Zip | 90049-2711
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Country | US
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Telephone | 424-500-5006
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Fax | 844-908-2227
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Provider Business Mailing Address
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Address Line | 375 HOMEWOOD RD
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City | LOS ANGELES
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State | CA
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Zip | 90049-2711
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Country | US
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Telephone | 424-500-5006
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | TBA
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND831
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License Number State | CA
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