Kathleen Anne Davis, RN; NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

9457 Issued in CA

Practice address

1241 E Dyer Rd Ste 1451241E
Santa Ana, CA 92705-5611

Phone

(949) 449-1112

NPI assigned

Dec 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Kathleen Ann Herr Other name

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.

• Omni Women's Health Medical Group, Inc

  • Clinical Medical Laboratory
  • Fresno, CA
  • NPI 1891997813
  NPD (past)
• Valley Women's Healthcare Medical Group, Inc

  • Obstetrics & Gynecology Physician
  • Fresno, CA
  • NPI 1154873230
  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427035344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 WOODMONT DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951181454",
            "telephone_number": "559-930-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 E DYER RD STE 1451241E",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055611",
            "telephone_number": "949-449-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3152 N Millbrook Ave",
            "address_2": "SUITE B",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031400",
            "country_code": "US",
            "telephone_number": "559-244-0133",
            "fax_number": "559-244-0148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "RN; NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "NP9457",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "336132",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "NP9457",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "9457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LIC",
            "identifier": "9457",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "336132",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "HERR",
            "middle_name": "ANN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Deborah Davis
• Desiree Davis
• Grace Davis
• Jennifer Lynn Davis, RN
• Kaitlyn Davis
• Logan Myles Davis
• Mark Allen Davis, PSYD
• Michael Davis
• Michelle R Davis, PA-C
• William F Davis, MD

• Primary Care Nurse Practitioner in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.