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NPI Code Detail

MEDICARE: DR. REZARTA DAVIS PH.D.

MEDICARE: DR. REZARTA DAVIS PH.D.
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
1101YP2500XProfessional Counselor11071CA

General Provider Information

NPI Number : 1275398703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REZARTA DAVIS PH.D.
Provider Business Mailing Address
First Line : 8835 VANS ST
Second Line :
City : PARAMOUNT
State : CA
Zip : 90723-4656
Country : US
Telephone Number : 562-633-5111
Fax Number :
Provider Business Practice Location Address
First Line : 8835 VANS ST
Second Line :
City : PARAMOUNT
State : CA
Zip : 90723-4656
Country : US
Telephone Number : 562-633-5111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2024
Last Update Date : 02/14/2024

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Directions to “ DR. REZARTA DAVIS PH.D.” Practice Location

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