NPIMap

Individual provider Active NPI

Tanaeyah Olivia Davis

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1326699224
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
137818 Issued in CA
Practice address
3850 Crenshaw Blvd
Los Angeles, CA 90008-1821
Phone
(310) 357-3933
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 137818 CA Primary
Social Worker 104100000X
Mental Health Counselor 101YM0800X 99358 GA
Clinical Social Worker 1041C0700X 99358 CA

Addresses

Primary practice location

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821

Mailing address

2610 Industry Way
Lynwood, CA 90262-4283

Other practice location 1

2610 Industry Way
Lynwood, CA 90262-4283
Phone (310) 631-8004

Other practice location 2

6762 Lexington Ave
Los Angeles, CA 90038-1217
Phone (323) 380-7590

Other practice location 3

1030 Fayetteville Rd SE
Atlanta, GA 30316
Phone (404) 486-9034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99358GAMDMental Health Counselor
137818CAMDClinical Social Worker
99358CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Health & Rehabilitation Program Past Accepting new patients
Southern California Health & Rehabilitation Program Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/scharpca/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1326699224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "310-357-3933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2610 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624283",
            "country_code": "US",
            "telephone_number": "310-631-8004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6762 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900381217",
            "country_code": "US",
            "telephone_number": "323-380-7590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1030 Fayetteville Rd SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30316",
            "country_code": "US",
            "telephone_number": "404-486-9034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TANAEYAH",
        "middle_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "137818",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "99358",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "99358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.