Active NPI
Gena Lynn Davis, O.D.
- Optometrist
- Gualala, CA
National Provider Identifier
1902050669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 8214T
- Practice address
- 39150 Ocean Drive
Suite 2a
Gualala, CA 95445 - Phone
- (707) 884-3937
- NPI assigned
- Nov 7, 2008
- Last updated
- Nov 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8214T | CA | Primary |
Addresses
Primary practice location
39150 Ocean Drive
Suite 2a
Gualala, CA 95445
Mailing address
PO Box 1088
Gualala, CA 95445-1088
Phone (707) 884-3937
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8214T | CA | MD | Optometrist |
| 8214 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226016000000",
"number": "1902050669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1088",
"city": "GUALALA",
"state": "CA",
"postal_code": "954451088",
"telephone_number": "707-884-3937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39150 OCEAN DRIVE",
"address_2": "SUITE 2A",
"city": "GUALALA",
"state": "CA",
"postal_code": "95445",
"telephone_number": "707-884-3937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "GENA",
"middle_name": "LYNN",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-07",
"last_updated": "2008-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "8214T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gualala, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.