Michael Anthony Davis I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1652 Sheridan Rd
San Bernardino, CA 92407-2817

Phone

(909) 693-6791

NPI assigned

Aug 31, 2016

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

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1760938534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 E DATE ST APT 118",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924048227",
            "telephone_number": "909-541-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 SHERIDAN RD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072817",
            "telephone_number": "909-693-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilham Elmi Davis, APCC
• Jesse Lee Davis
• Kathryn Marie Davis, PSY.D.
• Lashandia Davis
• Mia Davis
• Mylaka Davis
• Nate Yvonne Nicole Davis
• Samantha Elizabeth Davis, ACSW, CADC-CAS
• Sherronda Davis
• Susan Nmi Davis, LMFT

• Addiction (Substance Use Disorder) Counselor in San Bernardino, CA
• Providers in San Bernardino, 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 Feb 21, 2024; 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.