Brandyn Alisa Davis, ASW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW91553 Issued in CA

Practice address

312 S Lincoln St
Fort Bragg, CA 95437-4416

Phone

(530) 208-8335

NPI assigned

Aug 31, 2021

Last updated

Aug 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1689342180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 N MITCHELL CREEK RD",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378347",
            "telephone_number": "530-208-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S LINCOLN ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954374416",
            "telephone_number": "530-208-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRANDYN",
        "middle_name": "ALISA",
        "name_prefix": "Mrs.",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW91553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hallie J Davrill, LMFT
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• Dennis Paul Deluca Jr., CWC
• Prakash P Devaskar, MD
• Dialysis Clinic Inc.

• Clinical Social Worker in Fort Bragg, CA
• Providers in Fort Bragg, 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 Aug 31, 2021; 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.