Provider Demographics
NPI:1831255041
Name:DAVIS, CONSTANCE LOUISE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:LOUISE
Last Name:DAVIS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:710 LAWRENCE EXPY
Mailing Address - Street 2:DEPARTMENT 290
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5173
Mailing Address - Country:US
Mailing Address - Phone:408-851-2346
Mailing Address - Fax:408-851-2319
Practice Address - Street 1:710 LAWRENCE EXPY
Practice Address - Street 2:DEPARTMENT 290
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-2346
Practice Address - Fax:408-851-2319
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA15594363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical