Tia Davis, LMFT

Key facts

NPI

1114370970

Entity type

Individual (NPI type 1)

Primary specialty

Marriage & Family Therapist 106H00000X

License

111542 (CA)

Practice address

3960 Industrial Blvd Ste 200
West Sacramento, CA 95691-5024

Phone

(916) 287-3510

NPI assigned

Jul 18, 2016

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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.

• County of Sutter Adolescent and Children Mental Health Clinic/Center · Yuba City, CA · NPI 1235357229
  NPD (past)
• County of Sutter Adolescent and Children Mental Health Clinic/Center · Yuba City, CA · NPI 1285828061
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 4, 2019.

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1114370970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1520",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959921520",
            "telephone_number": "530-822-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 INDUSTRIAL BLVD STE 200",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956915024",
            "telephone_number": "916-287-3510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 Plumas St",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959914437",
            "country_code": "US",
            "telephone_number": "530-822-7478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TIA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93975",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in West Sacramento, CA · Marriage & Family Therapist in California