Active NPI
Jessica Deva Davisson
- Counseling Psychologist
- Eureka, CA
National Provider Identifier
1801655139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 94028165
- Practice address
- 350 E St Ste 305
Eureka, CA 95501-0351 - Phone
- (707) 677-8200
- NPI assigned
- Mar 18, 2024
- Last updated
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 94028165 | CA | Primary |
Addresses
Primary practice location
350 E St Ste 305
Eureka, CA 95501-0351
Mailing address
350 E St Ste 305
Eureka, CA 95501-0351
Phone (707) 677-8200
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94028165 | CA | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Growth Psychology Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1801655139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 E ST STE 305",
"city": "EUREKA",
"state": "CA",
"postal_code": "955010351",
"telephone_number": "707-677-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 E ST STE 305",
"city": "EUREKA",
"state": "CA",
"postal_code": "955010351",
"telephone_number": "707-677-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISSON",
"first_name": "JESSICA",
"middle_name": "DEVA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "94028165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.