Active NPI
Andrea Louise Davis, N.P.
- Nurse Practitioner
- Ukiah, CA
National Provider Identifier
1215259114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 19645
- Practice address
- 275 Hospital Dr
Ukiah, CA 95482-4531 - Phone
- (707) 462-7900
- Fax
- (707) 462-7947
- NPI assigned
- Feb 18, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 19645 | CA | Primary |
Addresses
Primary practice location
275 Hospital Dr
Ukiah, CA 95482-4531
Mailing address
PO Box 2800
Ukiah, CA 95482-2800
Phone (707) 462-7900
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19645 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1215259114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2800",
"city": "UKIAH",
"state": "CA",
"postal_code": "954822800",
"telephone_number": "707-462-7900",
"fax_number": "707-462-7947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 HOSPITAL DR",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824531",
"telephone_number": "707-462-7900",
"fax_number": "707-462-7947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANDREA",
"middle_name": "LOUISE",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-18",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "19645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.