Provider Demographics
NPI:1184045528
Name:DAVIS, NIESHA M (LCSW)
Entity Type:Individual
Prefix:
First Name:NIESHA
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12221
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-2221
Mailing Address - Country:US
Mailing Address - Phone:661-444-7450
Mailing Address - Fax:844-689-0922
Practice Address - Street 1:1701 WESTWIND DR STE 110
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3045
Practice Address - Country:US
Practice Address - Phone:661-444-7450
Practice Address - Fax:844-689-0922
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW869491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical