Active NPI
Kerry Ann Davis, PH.D.
- Forensic Psychologist
- Riverside, CA
National Provider Identifier
1396969879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 17727
- Practice address
- 231 E Alessandro Blvd
Suite a, Box 188
Riverside, CA 92508-6039 - Phone
- (951) 544-7661
- NPI assigned
- Apr 13, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 17727 | CA | Primary |
Addresses
Primary practice location
231 E Alessandro Blvd
Suite a, Box 188
Riverside, CA 92508-6039
Mailing address
231 E Alessandro Blvd
Suite a, Box 188
Riverside, CA 92508-6039
Phone (951) 544-7661
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17727 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1396969879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 E ALESSANDRO BLVD",
"address_2": "SUITE A, BOX 188",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925086039",
"telephone_number": "951-544-7661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 E ALESSANDRO BLVD",
"address_2": "SUITE A, BOX 188",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925086039",
"telephone_number": "951-544-7661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KERRY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "17727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.