Deatria Davis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2600 S. El Camino Real
San Mateo, CA 94403

Phone

(209) 752-1965

NPI assigned

Jan 5, 2012

Last updated

Jul 20, 2015By the provider in NPPES

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

Marriage and Family Therapist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

WK Medical GroupGroup PAC ID 6103116348, 19 clinicians

LGTC GroupGroup PAC ID 0749795102, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LGTC Group

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1881482941
  Medicare reassignment Care Compare group NPD
• WK Medical Group

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1588083992

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Davis Counseling and Therapeutic Services

  • Marriage & Family Therapist
  • Los Banos, CA
  • NPI 1912750860
  NPD Authorized official
• LGTC Inc

  dba LGTC

  • Registered Dietitian
  • San Jose, CA
  • NPI 1710749494
  NPD (past)
• Los Gatos Therapy Center

  dba LGTC Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1518600972
  NPD (past)

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1659641835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 GEE GEE AVE",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353278",
            "telephone_number": "209-752-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S. EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "209-752-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEATRIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medina Dautovic
• David M Isenman MD Inc
• Sarah Brown David, PSYD
• Aaron Davis, FDN
• Catherine Elizabeth Maxine Davis
• Margarie Davis, REGISTERED NURSE
• Sarah J Davis, M.A.
• Tyler Davis, DMD
• Zane Adam Davis
• Joshua Craig Hernandez Daya

• Mental Health Counselor in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.