Pamela Renee Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23108 Issued in CA

Practice address

321 E Erwin St
Rialto, CA 92376-6018

Phone

(909) 559-4307

NPI assigned

Apr 5, 2019

Sex

Female

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Live Well Family Counseling Services

  • Marriage & Family Therapist
  • Temecula, CA
  • NPI 1750971180

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1760944904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E ERWIN ST",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923766018",
            "telephone_number": "909-559-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E ERWIN ST",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923766018",
            "telephone_number": "909-559-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PAMELA",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "23108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Lynn Davis
• Danette Noel Davis
• Ellen Latoya Davis
• Emily Michelle Davis
• Michael Davis
• Leslie Dawson
• Jalise Vernae De la Cruz
• Jorge De la Cruz
• Maria Isabel De la Rosa Torres, BCBA
• Elizabeth Rosemary De la Torre

• Clinical Social Worker in Rialto, CA
• Providers in Rialto, 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 Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.