Individual provider Active NPI

Kendra Davis, LCS24637

  • Clinical Social Worker
  • Yuba City, CA
National Provider Identifier
1255794467
Registry record updated Nov 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS24637 Issued in CA
Practice address
1007 Live Oak Blvd Ste B-1
Yuba City, CA 95991-3454
Phone
(530) 632-7894
NPI assigned
Apr 4, 2016
Last updated
Nov 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS24637 CA Primary

Addresses

Primary practice location

1007 Live Oak Blvd Ste B-1
Yuba City, CA 95991-3454

Mailing address

3115 Stonegate Dr
Yuba City, CA 95993-8815
Phone (530) 632-7894

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170913001128 CA Practitioner - Clinical Social Worker 4789859893 Reassigns benefits to 5 organizations
Practice locations: Yuba City, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1445 Butte House Rd
Yuba City, CA 95993-2749
Phone (530) 632-7894

3115 Stonegate Dr
Yuba City, CA 95993-8815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS24637CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blossom Ridge Medical, Inc. CurrentSince May 1, 2025 Accepting new patients
Jasbir S Kang MD & Sanjiv Midha MD a Medical Corporation CurrentSince May 1, 2025 Accepting new patients
North Valley Nephrology Inc CurrentSince May 1, 2025 Accepting new patients
Kesav Health and Wellness Licensed Clinical Social Worker PC Clinical CurrentSince Jul 11, 2024 Accepting new patients

Locations

527 E St
Marysville, CA 95901
Phone (530) 743-5300

2554 Millcreek Dr
Sacramento, CA 95833
Phone (800) 991-6147

1525 Plumas Ct
Ste B
Yuba City, CA 95991
Phone (530) 671-4980

1215 Plumas St
Ste 1900
Yuba City, CA 95991
Phone (530) 674-2100

1007 Live Oak Blvd
Ste B1
Yuba City, CA 95991
Phone (530) 632-7894

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1255794467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 STONEGATE DR",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959938815",
            "telephone_number": "530-632-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LIVE OAK BLVD STE B-1",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913454",
            "telephone_number": "530-632-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KENDRA",
        "credential": "LCS24637",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS24637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.