Active NPI
Kim Davis, PH.D.
- Clinical Psychologist
- Encino, CA
National Provider Identifier
1386760387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY21796
- Practice address
- 16055 Ventura Blvd Ste 1033
Encino, CA 91436 - Phone
- (310) 281-6645
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | RPS 2006 098 | CA | |
| Clinical Psychologist | 103TC0700X | PSY21796 | CA | Primary |
Addresses
Primary practice location
16055 Ventura Blvd Ste 1033
Encino, CA 91436
Mailing address
11738 Otsego St
Valley Village, CA 91607-3221
Phone (310) 709-6020
Other practice location 1
3200 Motor Ave
Los Angeles, CA 90034-3710
Phone (310) 836-1223 ext. 275
Other practice location 2
16055 Ventura Blvd Ste 1033
Encino, CA 91436
Phone (310) 281-6645
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPS 2006 098 | CA | MD | Mental Health Counselor |
| PSY21796 | CA | MD | Clinical Psychologist |
| 21796 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545782400000",
"number": "1386760387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11738 OTSEGO ST",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916073221",
"telephone_number": "310-709-6020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16055 VENTURA BLVD STE 1033",
"city": "ENCINO",
"state": "CA",
"postal_code": "91436",
"telephone_number": "310-281-6645"
}
],
"practiceLocations": [
{
"address_1": "3200 Motor Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900343710",
"country_code": "US",
"telephone_number": "310-836-1223 x275",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16055 Ventura Blvd Ste 1033",
"address_purpose": "LOCATION",
"city": "Encino",
"state": "CA",
"postal_code": "91436",
"country_code": "US",
"telephone_number": "310-281-6645",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "KIM",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2018-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "RPS 2006 098",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY21796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.