NPIMap

Individual provider Active NPI

Terrell R Davis, CADC II

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1336564475
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2445 W Whites Bridge Ave
Fresno, CA 93706
Phone
(553) 264-5096
NPI assigned
Feb 26, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

2445 W Whites Bridge Ave
Fresno, CA 93706

Mailing address

2445 W Whites Bridge Ave
Fresno, CA 93706-1225
Phone (559) 264-5096

Other practice location 1

2302 S Martin L King Jr Blvd
Fresno, CA 93706-4135
Phone (559) 442-0400

Other practice location 2

2445 W Whites Bridge Ave
Fresno, CA 93706
Phone (553) 264-5096 ext. 17

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

Practice roles

OrganizationSpecialtyStatusNew patients
King of Kings Outpatient and Perinatal Services Program Past Accepting new patients
King of Kings Community Center Past Accepting new patients
Comprehensive Addictions Program Past Accepting new patients
Comprehensive Addiction Programs Inc Past Accepting new patients

Organizations & group practices 4

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": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1336564475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 W WHITES BRIDGE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937061225",
            "telephone_number": "559-264-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 W WHITES BRIDGE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93706",
            "telephone_number": "553-264-5096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2302 S Martin L King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937064135",
            "country_code": "US",
            "telephone_number": "559-442-0400",
            "fax_number": "559-442-0401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2445 W Whites Bridge Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93706",
            "country_code": "US",
            "telephone_number": "553-264-5096 x17",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TERRELL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "CADC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-26",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.