Provider Demographics
NPI:1720212970
Name:DAVIS, DEBORAH THORNTON
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:THORNTON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38966 BLUEBELL DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-4904
Mailing Address - Country:US
Mailing Address - Phone:510-494-9447
Mailing Address - Fax:510-494-9537
Practice Address - Street 1:38966 BLUEBELL DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-4904
Practice Address - Country:US
Practice Address - Phone:510-494-9447
Practice Address - Fax:510-494-9537
Is Sole Proprietor?:No
Enumeration Date:2009-05-02
Last Update Date:2009-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program