Active NPI
Judith M Davis, M.D.
- Psychiatry Physician
- Walnut Creek, CA
National Provider Identifier
1740428358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G13583
- Practice address
- 1450 Creekside Dr
#36
Walnut Creek, CA 94596-5558 - Phone
- (925) 705-5191
- NPI assigned
- Feb 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G13583 | CA | Primary |
| Psychiatry Physician | 2084P0800X | 36-48264 | IL |
Addresses
Primary practice location
1450 Creekside Dr
#36
Walnut Creek, CA 94596-5558
Mailing address
1450 Creekside Dr
#36
Walnut Creek, CA 94596-5558
Phone (925) 705-5191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36-48264 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1740428358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 CREEKSIDE DR",
"address_2": "#36",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965558",
"telephone_number": "925-705-5191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 CREEKSIDE DR",
"address_2": "#36",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965558",
"telephone_number": "925-705-5191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JUDITH",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-04",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G13583",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "36-48264",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.