Davis Developmental Pediatrics Group, Inc

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

A078949 Issued in CA

Legal business name

DAVIS DEVELOPMENTAL PEDIATRICS GROUP, INC

Practice address

1321 College St
Suite E
Woodland, CA 95695-4706

Phone

(530) 758-3374

Fax

(530) 746-0657

NPI assigned

Jan 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Stephen T Nowicki, MD, PHD

Title

Physician, President

Phone

(530) 220-3039

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1295049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1275838690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2747 GANGES PL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956162921",
            "telephone_number": "530-758-3374",
            "fax_number": "530-758-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLLEGE ST",
            "address_2": "SUITE E",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956954706",
            "telephone_number": "530-758-3374",
            "fax_number": "530-746-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS DEVELOPMENTAL PEDIATRICS GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-15",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "NOWICKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN, PRESIDENT",
        "authorized_official_telephone_number": "530-220-3039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "A078949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Timothy Martin Davis, D.O.
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• Developmental - Behavioral Pediatrics Physician in Woodland, CA
• Providers in Woodland, CA by specialty
• Developmental - Behavioral Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.