Jill Davidson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14343 Issued in CA

Practice address

12516 Sanford St
Los Angeles, CA 90066-6935

Phone

(310) 922-5638

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1306465976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12516 SANFORD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666935",
            "telephone_number": "310-922-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12516 SANFORD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666935",
            "telephone_number": "310-922-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JILL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "14343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jill_miyamoto@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12516 Sanford St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900666935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Davidson Marriage and Family Therapy Group Inc
• Davidson Marriage and Family Therapy Professional Corporation
• Bahareh Rebecca Davidson, PHARMD
• Cheyanne Trichelle Davidson
• Jered Robert Davidson
• Karlton C Davidson
• Kathleen M Davidson, OTR/L
• Linda A. Davidson, L.C.S.W.
• Mark Mehrdad Davidson, M.D.
• Mayer B. Davidson, M.D.

• Speech-Language Pathologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.