Alex Davidson

Individual provider Active NPI Case Manager/Care Coordinator · Colusa, CA

NPI 1346774635 · NPPES record last updated Dec 7, 2021

Key facts

NPI
1346774635
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
162 E Carson St
Colusa, CA 95932-2880
Phone
(530) 473-9215
NPI assigned
Apr 13, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

162 E Carson St
Colusa, CA 95932-2880

Mailing address

162 E Carson St
Colusa, CA 95932-2880
Phone (530) 473-9215

Other providers in Colusa, CA

All providers in Colusa, CA · Case Manager/Care Coordinator in California

Sources for this page

Verify at the official NPI Registry.