MEDICARE: JADAE 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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1881554764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADAE DAVIS

Provider Business Mailing Address
First Line	:	24105 W FLORES DR
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-6088
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 S MILLER RD BLDG C
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-1503
Country	:	US
Telephone Number	:	623-628-8788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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Directions to “ JADAE DAVIS ” Practice Location

Language	Start Address	Practice Location

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