Divergent Healing

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVERGENT HEALING

Practice address

1902 Wright PL Ste 200
Carlsbad, CA 92008-6583

Phone

(951) 477-7745

NPI assigned

Feb 6, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Devaughn J Davis

Title

Owner

Phone

(951) 477-7745

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1871307124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 WRIGHT PL STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920086583",
            "telephone_number": "951-477-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 WRIGHT PL STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920086583",
            "telephone_number": "951-477-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGENT HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DEVAUGHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-477-7745",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.