Provider Demographics
NPI:1184152753
Name:DAVIS, RICA ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:RICA
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 EL CAMINO REAL STE 204
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-1609
Mailing Address - Country:US
Mailing Address - Phone:760-448-8100
Mailing Address - Fax:
Practice Address - Street 1:6260 EL CAMINO REAL STE 204
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-1609
Practice Address - Country:US
Practice Address - Phone:760-448-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily