Dallas R Davis

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

5473 Kearny Villa Rd Ste 300
San Diego, CA 92123-1142

Phone

(619) 605-9393

Fax

(619) 684-7004

NPI assigned

Jun 6, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1447144068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5473 KEARNY VILLA RD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231142",
            "telephone_number": "619-605-9393",
            "fax_number": "619-684-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5473 KEARNY VILLA RD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231142",
            "telephone_number": "619-605-9393",
            "fax_number": "619-684-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DALLAS",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "21055",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantal Lorraine Davis, L.AC.
• Charles B. Davis, M.D.
• Christie Ann Davis, CADC-II CA
• Christopher Kent Davis, MD
• Creston Davis, THERAPIST
• Danita Davis, LMFT
• David Ian Davis, M.A.
• Davon Myon Davis, PTA
• Dcarla Davis
• Deirdre Shawna Davis, MD

• Rehabilitation Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Rehabilitation Practitioner in California

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