Provider Demographics
NPI:1164668893
Name:DAVIS, MARCIA LEE (FSC1)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:LEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FSC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 A ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3649
Mailing Address - Country:US
Mailing Address - Phone:530-601-5600
Mailing Address - Fax:
Practice Address - Street 1:600 A ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-3649
Practice Address - Country:US
Practice Address - Phone:530-601-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor