Provider Demographics
NPI:1275565301
Name:DAVIS, ANN ELIZABETH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5500 TELEGRAPH RD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4250
Mailing Address - Country:US
Mailing Address - Phone:805-642-2234
Mailing Address - Fax:805-642-2234
Practice Address - Street 1:5500 TELEGRAPH RD
Practice Address - Street 2:SUITE 175
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4250
Practice Address - Country:US
Practice Address - Phone:805-642-2234
Practice Address - Fax:805-642-2234
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAMFT#41837106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA418370OtherBLUE SHIELD OF CA ID