Crystal Denise Davis, MA

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

106500000X Issued in CA

Practice address

6809 Indiana Ave
Riverside, CA 92506-4221

Phone

(951) 774-1338

NPI assigned

Oct 7, 2022

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1902521347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 INDIANA AVE STE 154",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064221",
            "telephone_number": "909-268-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 INDIANA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064221",
            "telephone_number": "951-774-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CRYSTAL",
        "middle_name": "DENISE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "106500000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106500000X",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BDSInspired.com",
            "affiliation": "N",
            "endpointDescription": "BDSinspired.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "6809 Indiana Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925064221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Korinne Elon Davis-Lobban, LMFT
• Abigail Victoria Davis
• Amanda Charlotte-Weinland Davis
• Ashley Y Davis
• Barry Davis, O.T.
• David Alan Davis, MSW
• Dean Davis
• Geia Sotto Davis, NP-C
• Janae Breeanna Davis
• Janet Stoia Davis, RN CWOCN

• Behavior Technician in Riverside, CA
• Providers in Riverside, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.