Provider Demographics
NPI:1407984750
Name:DAVIS, WHITNEY ERIN (PT)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:ERIN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:WHITNEY
Other - Middle Name:ERIN
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1110 MIEL ST
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-8775
Mailing Address - Country:US
Mailing Address - Phone:209-401-8479
Mailing Address - Fax:
Practice Address - Street 1:1800 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6019
Practice Address - Country:US
Practice Address - Phone:209-467-6365
Practice Address - Fax:209-467-6465
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist