Active NPI
Miriam Davis, M.F.T.
- Marriage & Family Therapist
- Burbank, CA
National Provider Identifier
1073735080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC31571
- Practice address
- 2625 West Alameda Avenue
Suite 514
Burbank, CA 91505 - Phone
- (818) 848-3022
- Fax
- (818) 895-6936
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC31571 | CA | Primary |
Addresses
Primary practice location
2625 West Alameda Avenue
Suite 514
Burbank, CA 91505
Mailing address
2625 West Alameda Avenue
Suite 514
Burbank, CA 91505
Phone (818) 848-3022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ44196Z | Other | CA | BLUE SHIELD BLUE CARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC31571 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073735080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 WEST ALAMEDA AVENUE",
"address_2": "SUITE 514",
"city": "BURBANK",
"state": "CA",
"postal_code": "91505",
"telephone_number": "818-848-3022",
"fax_number": "818-895-6936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 WEST ALAMEDA AVENUE",
"address_2": "SUITE 514",
"city": "BURBANK",
"state": "CA",
"postal_code": "91505",
"telephone_number": "818-848-3022",
"fax_number": "818-895-6936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MIRIAM",
"credential": "M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC31571",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD BLUE CARD",
"identifier": "ZZZ44196Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.