Active NPI
Jennifer Davis, PSYD
- Clinical Psychologist
- Oakland, CA
National Provider Identifier
1437466182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 29077
- Practice address
- 1124 International Blvd
Oakland, CA 94606-4331 - Phone
- (510) 533-0800
- NPI assigned
- Sep 1, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 29077 | CA | Primary |
Addresses
Primary practice location
1124 International Blvd
Oakland, CA 94606-4331
Mailing address
23370 Road 22
Chowchilla, CA 93610-8504
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29077 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1437466182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23370 ROAD 22",
"city": "CHOWCHILLA",
"state": "CA",
"postal_code": "936108504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1124 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946064331",
"telephone_number": "510-533-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-01",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "29077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.