Eugenia L Davis

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

B106161 Issued in CA

Practice address

8803 Fox Creek Dr
Stockton, CA 95210-1783

Phone

(209) 353-9140

Fax

(209) 298-7647

NPI assigned

Aug 29, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Eugenia L Holbert Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1508641390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR STE G",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075267",
            "telephone_number": "209-353-9140",
            "fax_number": "209-268-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 FOX CREEK DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952101783",
            "telephone_number": "209-353-9140",
            "fax_number": "209-298-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EUGENIA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "B106161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUGENIA",
            "last_name": "HOLBERT",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "LICENSED BARBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitchell Samuel Davies
• Davinder S. Manak DDS. Incorporation
• Catherine Davis, NP
• Dinah Lee Davis
• Emalia Davis, HIS
• Guy George Davis, DDS
• Heather Davis, RD
• James Davis
• Jennifer Davis
• Keleena Davis

• Prosthetic/Orthotic Supplier in Stockton, CA
• Providers in Stockton, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.