Jillian Diane Davidson, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

633004 Issued in CA

Practice address

441 N Main St
Alturas, CA 96101-3457

Phone

(530) 233-6311

Fax

(530) 233-6339

NPI assigned

Sep 9, 2013

Last updated

Sep 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1891120952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 N MAIN ST",
            "city": "ALTURAS",
            "state": "CA",
            "postal_code": "961013457",
            "telephone_number": "530-233-6311",
            "fax_number": "530-233-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N MAIN ST",
            "city": "ALTURAS",
            "state": "CA",
            "postal_code": "961013457",
            "telephone_number": "530-233-6311",
            "fax_number": "530-233-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JILLIAN",
        "middle_name": "DIANE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "633004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Ann Conger, LVN
• Carmen Marie Coronado, CASE MANAGER
• County of Modoc
• County of Modoc (Modoc County Sheriff's Office)
• Richard James Crosby Jr.
• Cindy Marie Deiter
• Guillermo Diaz, MBA
• Dr. Kyle Dearing, O.D, Inc
• Edward P. Richert, M.D., Inc.
• Heidi Lynn Elmer

• Psychiatric/Mental Health Registered Nurse in Alturas, CA
• Providers in Alturas, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.