Creston Davis, THERAPIST

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

51024 Issued in CA

Practice address

2725 Congress St Ste 1D
San Diego, CA 92110-2783

Phone

(619) 288-6866

NPI assigned

Nov 23, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Institute of Modern Recovery

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1952714321
  NPD Authorized official

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737849600000",
    "number": "1285936278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 CONGRESS ST",
            "address_2": "SUITE 1D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102783",
            "telephone_number": "619-288-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CONGRESS ST STE 1D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102783",
            "telephone_number": "619-288-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CRESTON",
        "name_prefix": "Mr.",
        "credential": "THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-23",
        "last_updated": "2025-01-26",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "51024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "87-4153810",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlee Davis
• Chantal Lorraine Davis, L.AC.
• Charles B. Davis, M.D.
• Christie Ann Davis, CADC-II CA
• Christopher Kent Davis, MD
• Dallas R Davis
• Danita Davis, LMFT
• David Ian Davis, M.A.
• Davon Myon Davis, PTA
• Dcarla Davis

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2025; 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.