Individual provider Active NPI

Dena Marie Davis, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Commerce, CA
National Provider Identifier
1508412214
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95013847 Issued in CA
Practice address
1436 Goodrich Blvd
Commerce, CA 90022-5111
Phone
(233) 725-1337
NPI assigned
Aug 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95013847 CA Primary
Registered Nurse 163W00000X 811654 CA

Addresses

Primary practice location

1436 Goodrich Blvd
Commerce, CA 90022-5111

Mailing address

1436 Goodrich Blvd
Commerce, CA 90022-5111
Phone (233) 725-1337

Other practice location 1

160 S 7th Ave
LA Puente, CA 91746-3211
Phone (626) 961-8971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910002297 CA Practitioner - Nurse Practitioner 8325588908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Enki Health Services IncGroup PAC ID 8022926559, 25 clinicians

Practice addresses (Care Compare)

1436 Goodrich Blvd
Commerce, CA 90022-5111
Phone (323) 725-1337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013847CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enki Health Services, Inc. CurrentSince Aug 27, 2024 Accepting new patients
Enki Health Services, Inc. CurrentSince Aug 27, 2024 Accepting new patients
Enki Health Services, Inc. Current Accepting new patients

Locations

6001 Clara St
Bell Gardens, CA 90201
Phone (562) 806-5000

150 E Olive Ave
Ste 203
Burbank, CA 91502
Phone (818) 973-4899

1436 Goodrich Blvd
Commerce, CA 90022
Phone (323) 725-1337

3208 Rosemead Blvd
Ste 100
El Monte, CA 91731
Phone (626) 227-7001

160 S 7th Ave
La Puente, CA 91746
Phone (626) 961-8971

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1508412214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 GOODRICH BLVD",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900225111",
            "telephone_number": "233-725-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 GOODRICH BLVD",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900225111",
            "telephone_number": "233-725-1337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 S 7th Ave",
            "address_purpose": "LOCATION",
            "city": "LA Puente",
            "state": "CA",
            "postal_code": "917463211",
            "country_code": "US",
            "telephone_number": "626-961-8971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DENA",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95013847",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "811654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, CA

Sources for this page

Verify at the official NPI Registry.