Darrell Davis, RADTI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1341970319 Issued in CA

Practice address

9705 Holmes Ave
Los Angeles, CA 90002-3031

Phone

(323) 249-9097

Fax

(323) 249-9121

NPI assigned

Aug 12, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Canon Human Services Centers Inc

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1437582186
  NPD (past)
• Canon Human Services Centers, Inc,

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1558753004
  NPD (past)

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1669083754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9705 HOLMES AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023031",
            "telephone_number": "323-249-9097",
            "fax_number": "323-249-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 HOLMES AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023031",
            "telephone_number": "323-249-9097",
            "fax_number": "323-249-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DARRELL",
        "credential": "RADTI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1341970319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Davis, DPT
• Consuelo V Davis, LMFT
• Crystal Davis
• Cynthia Ann Davis
• Daniela Sloninsky Davis, MD
• Deandra Mishelle Davis
• Deandre Lamar Davis
• Detris Denise Davis
• Dillesha Davis
• Dion Davis, LMFT

• Addiction (Substance Use Disorder) Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.