Brandyn Alisa Davis, ASW
Individual provider Active NPI Clinical Social Worker · Fort Bragg, CA
NPI 1689342180 · NPPES record last updated Aug 31, 2021
Key facts
- NPI
- 1689342180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- ASW91553 (CA)
- Practice address
- 312 S Lincoln St
Fort Bragg, CA 95437-4416 - Phone
- (530) 208-8335
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW91553 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW91553 | CA | Yes |
Addresses
Primary practice location
312 S Lincoln St
Fort Bragg, CA 95437-4416
Mailing address
31700 N Mitchell Creek Rd
Fort Bragg, CA 95437-8347
Phone (530) 208-8335
Other providers in Fort Bragg, CA
- Sean Crawford
- Donna Louise Crikos
- Cynthia Audo
- Andrea D'Souza
- Edgar Damian
- Hallie J Davrill
- Jennifer C. De'Lavigne
- Dennis Paul Deluca Jr.
- Prakash P Devaskar
- Dialysis Clinic Inc.
All providers in Fort Bragg, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.