Tynisha White-Davies

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

89886 Issued in CA

Practice address

1720 E 120TH St
Los Angeles, CA 90059-3052

Phone

(323) 298-6180

NPI assigned

Aug 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1083633929
  Medicare reassignment Care Compare group NPD
• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1528427184
  NPD
• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arcadia, CA
  • NPI 1902676075
  NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1578089199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593052",
            "telephone_number": "323-298-3680",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593052",
            "telephone_number": "323-298-6180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 S Beaudry Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90017",
            "country_code": "US",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6055 E Washington Blvd Ste 900",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900402453",
            "country_code": "US",
            "telephone_number": "323-346-0960 x210",
            "fax_number": "323-346-0966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE-DAVIES",
        "first_name": "TYNISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "89886",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "89886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Memorial Medical Group, Inc.
• White Memorial Medical Group, Inc.
• White Memorial Medical Plaza Pharmacy Services Inc
• White Memorial Medical Plaza Pharmacy Services Inc
• White Memorial Otolaryngology Foundation
• Barbara Dean White-Jones, FNP
• Christham White-Windross, N.P.
• Alan K White, MA
• Alexandra Jeanne White
• Alison White, APRN

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.