Provider Demographics
NPI:1205392008
Name:DAVIS, ANDREW MARSHALL (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MARSHALL
Last Name:DAVIS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7233 W SAN CARLOS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93723-9578
Mailing Address - Country:US
Mailing Address - Phone:310-415-5443
Mailing Address - Fax:
Practice Address - Street 1:320 E WARNER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3711
Practice Address - Country:US
Practice Address - Phone:559-252-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-16
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126415106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist