Provider Demographics
NPI:1669181590
Name:DAVIS, PIA LOUISE (AMFT)
Entity type:Individual
Prefix:
First Name:PIA
Middle Name:LOUISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 ANCHORS WAY UNIT 208
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-4336
Mailing Address - Country:US
Mailing Address - Phone:213-235-8425
Mailing Address - Fax:
Practice Address - Street 1:2021 SPERRY AVE STE 41
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7417
Practice Address - Country:US
Practice Address - Phone:805-669-8846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT135165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty