Active NPI
Ella Mamanta Davidson
- Counselor
- Berkeley, CA
National Provider Identifier
1982371589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 904 Panoramic Way
Berkeley, CA 94704-2540 - Phone
- (845) 705-0371
- NPI assigned
- Aug 23, 2021
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
904 Panoramic Way
Berkeley, CA 94704-2540
Mailing address
904 Panoramic Way
Berkeley, CA 94704-2540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 13, 2026 through Jul 13, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1982371589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 PANORAMIC WAY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 PANORAMIC WAY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042540",
"telephone_number": "845-705-0371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "ELLA",
"middle_name": "MAMANTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-23",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.