Individual provider Active NPI

Harriette Felicia Davidson

  • Psychiatric/Mental Health Nurse Practitioner
  • Redding, CA
National Provider Identifier
1598512725
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
711031 Issued in CA
Practice address
457 Knollcrest Dr
Redding, CA 96002-0121
Phone
(530) 392-4399
NPI assigned
May 6, 2024
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 711031 CA Primary

Addresses

Primary practice location

457 Knollcrest Dr
Redding, CA 96002-0121

Mailing address

PO Box 1434
Joshua Tree, CA 92252-0840
Phone (954) 909-6593

Other practice location 1

PO Box 1434
Joshua Tree, CA 92252-0840
Phone (954) 909-6593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1809 W Redlands Blvd
Redlands, CA 92373-8054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
711031CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enlighten Mental Health Psychiatric/Mental Health Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1598512725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1434",
            "city": "JOSHUA TREE",
            "state": "CA",
            "postal_code": "922520840",
            "telephone_number": "954-909-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 KNOLLCREST DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020121",
            "telephone_number": "530-392-4399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 1434",
            "address_purpose": "LOCATION",
            "city": "Joshua Tree",
            "state": "CA",
            "postal_code": "922520840",
            "country_code": "US",
            "telephone_number": "954-909-6593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "HARRIETTE",
        "middle_name": "FELICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "711031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.