Individual provider Active NPI

Stephanie Lynn Davidson, AMFT #93103

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1255771010
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
93103 Issued in CA
Practice address
600 W Santa Ana Blvd # 107-109
Santa Ana, CA 92701-4558
Phone
(714) 667-7926
NPI assigned
Jun 26, 2013
Last updated
Oct 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 93103 CA Primary

Addresses

Primary practice location

600 W Santa Ana Blvd # 107-109
Santa Ana, CA 92701-4558

Mailing address

201 W Collins Ave SPC 93
Orange, CA 92867-5612
Phone (310) 408-2766

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

LicenseStateTypeSpecialty
93103CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1255771010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W COLLINS AVE SPC 93",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675612",
            "telephone_number": "310-408-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W SANTA ANA BLVD # 107-109",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014558",
            "telephone_number": "714-667-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "AMFT #93103",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.