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General NPI Number Information
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NPI Number | 1649478595
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Entity Type | Individual
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Provider Name | GINA ANN DAVIS RN, NP, PMHNP, MSN
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 2640 BRESLAUER WAY SHASTA CO HEALTH&HUMAN SVC, MENTAL HEALTH BRANCH
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City | REDDING
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State | CA
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Zip | 96001-4246
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Country | US
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Telephone | 530-229-8041
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Fax | 530-225-3866
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Provider Business Mailing Address
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Address Line | 4985 TRALEE LN
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City | REDDING
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State | CA
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Zip | 96001-6007
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Country | US
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Telephone | 530-246-3389
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Fax | 530-246-1622
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11239
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 11239
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License Number State | CA
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