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NPI Code Detail

MEDICARE: MARQUISHA E DAVIS

MEDICARE:   MARQUISHA E DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1023729068
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARQUISHA E DAVIS
Provider Business Mailing Address
First Line : 1242 RIVER GLEN ROW UNIT 42
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-7414
Country : US
Telephone Number : 619-713-8065
Fax Number :
Provider Business Practice Location Address
First Line : 1242 RIVER GLEN ROW UNIT 42
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-7414
Country : US
Telephone Number : 619-713-8065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2022
Last Update Date : 12/12/2022

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Directions to “ MARQUISHA E DAVIS ” Practice Location

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