Provider Demographics
NPI:1902016975
Name:DAVIS, JAMES FRANKLIN (MFT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:FRANKLIN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 D ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-4820
Mailing Address - Country:US
Mailing Address - Phone:530-713-1223
Mailing Address - Fax:
Practice Address - Street 1:4240 DAN AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-8107
Practice Address - Country:US
Practice Address - Phone:530-741-6275
Practice Address - Fax:530-749-7913
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41806106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC41806OtherMFT