Jason Brant Davidson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

771967 Issued in CA

Practice address

36205 Ketchum Rd
Wildomar, CA 92595-7553

Phone

(951) 544-9532

NPI assigned

Mar 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553385600000",
    "number": "1285194233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36205 KETCHUM RD",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36205 KETCHUM RD",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957553",
            "telephone_number": "951-544-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JASON",
        "middle_name": "BRANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2019-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "771967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andi D'Oleo, RBT
• Stephen A Dada, M.D.
• Parima Daroui, M.D. PH.D.
• Vianney Davalos-Barreto
• Michael A Davalos, PA, MS
• Jaylin Davies
• Samantha Davies
• A Alex Davila, M.D.
• Shelby Day
• Dbia Igwe Medical Inc

• Registered Nurse in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.