Provider Demographics
NPI:1811221948
Name:DAVIS, APRIL GRACE (OTR/L)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:GRACE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 GROVE ST
Mailing Address - Street 2:APT. A
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-4761
Mailing Address - Country:US
Mailing Address - Phone:707-972-1808
Mailing Address - Fax:
Practice Address - Street 1:311 PROFESSIONAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2152
Practice Address - Country:US
Practice Address - Phone:707-591-0170
Practice Address - Fax:707-591-0171
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 10332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist