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General NPI Number Information
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NPI Number | 1912750860
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Entity Type | Organization
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Legal Business Name | DAVIS COUNSELING AND THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 1350 E PACHECO BLVD
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City | LOS BANOS
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State | CA
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Zip | 93635
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Country | US
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Telephone | 209-270-8799
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Fax |
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Provider Business Mailing Address
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Address Line | 8840 SAN YSIDRO AVE
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City | GILROY
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State | CA
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Zip | 95020-3682
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Country | US
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Telephone | 209-270-8799
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEATRIA DAVIS
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Credential | LMFT
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Telephone | 209-752-1965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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