Keegan Patrick Davis

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

94028803 Issued in CA

Practice address

1361 N Farris Ave
Fresno, CA 93728-1519

Phone

(559) 708-7704

NPI assigned

Jan 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advanced Behavioral Concepts

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
  • NPI 1427801851
  NPD Authorized official
• Transitions Children'S Services

  • Case Management Agency
  • Fresno, CA
  • NPI 1245674324
  NPD (past)
• Transitions Children'S Services

  • Foster Care Agency
  • Fresno, CA
  • NPI 1255715504
  NPD (past)

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1376909390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 N FARRIS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937281519",
            "telephone_number": "559-708-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 N FARRIS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937281519",
            "telephone_number": "559-708-7704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 N Helm Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271670",
            "country_code": "US",
            "telephone_number": "559-222-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3769 W Wathen Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937110853",
            "country_code": "US",
            "telephone_number": "559-708-7704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1204 W Shaw Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113706",
            "country_code": "US",
            "telephone_number": "559-273-2942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5610 W Donner Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937223721",
            "country_code": "US",
            "telephone_number": "559-313-9701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7658 N Santa Fe Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937222391",
            "country_code": "US",
            "telephone_number": "559-313-9701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3043 W Roberts Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937112160",
            "country_code": "US",
            "telephone_number": "559-313-9701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEEGAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "9012",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "94028803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ieasha Eboney Davis
• James Davis
• Jarell Anthony Davis
• Jason Davis
• Judy Jean Davis, MD
• Kentravis Davis
• Lauren Ashley Davis
• Lealani Naomi Davis
• Macy Davis
• Maria Guadalupe Davis, MSW, ACSW

• Clinical Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.