Provider Demographics
NPI:1457404972
Name:DAVIES, JOAN FLORENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:FLORENCE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 2ND STREET
Mailing Address - Street 2:SUITE 219
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0488
Mailing Address - Country:US
Mailing Address - Phone:707-444-0448
Mailing Address - Fax:707-444-0450
Practice Address - Street 1:525 2ND STREET
Practice Address - Street 2:SUITE 219
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0488
Practice Address - Country:US
Practice Address - Phone:707-444-0448
Practice Address - Fax:707-444-0450
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41601207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology