Stephen Glen Davis II, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25207 Issued in CA

Practice address

222 Butte St
Yreka, CA 96097-3003

Phone

(530) 905-0176

NPI assigned

Jun 3, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Department of State Hospitals

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Norwalk, CA
  • NPI 1265406565
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1063892164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 BUTTE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973003",
            "telephone_number": "530-905-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BUTTE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973003",
            "telephone_number": "530-905-0176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Butte St",
            "address_purpose": "LOCATION",
            "city": "Yreka",
            "state": "CA",
            "postal_code": "960973003",
            "country_code": "US",
            "telephone_number": "530-905-0176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24511 W Jayne Ave",
            "address_purpose": "LOCATION",
            "city": "Coalinga",
            "state": "CA",
            "postal_code": "932109503",
            "country_code": "US",
            "telephone_number": "559-934-8265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "STEPHEN",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "address_1": "222 Butte St",
            "city": "Yreka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "960973003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cheyenne Carmen Rose Davis, B.A.
• Haley Davis
• Linda Sue Davis
• Monte Kirk Davis, BHS II
• Shelly R Davis, MN BSN-RN PHN CCHP
• Sharon Kay Dawson, CRNFA
• Louis Derouchey, MD
• Michel-Ann R Dias, M.D.
• Tracee Diaz
• Deborah Carol Dickens

• Clinical Psychologist in Yreka, CA
• Providers in Yreka, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.