MR. KEITH GERARD DAVIS (NPI# 1104169127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104169127 |
| Entity Type | Individual |
| Full Name | MR. KEITH GERARD DAVIS |
| Practice Address |
4715 Crenshaw Blvd Los Angeles CA 90043-1233 |
| Practice Telephone | 3239883744 |
| Mailing Telephone | 3239883744 |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225668213 | Keith Davis | Registered Nurse | 10 Elpaso Ct, East Northport, NY 11731-5628 | 2020-01-19 |
| 1184183758 | Keith J Davis | Psychologist | 8113 Crimson Creek Ct, Las Vegas, NV 89139-6909 | 2019-03-13 |
| 1982115036 | Keith W Davis | Chiropractor | 815 E Baseline Rd Ste 106, Tempe, AZ 85283-1572 | 2017-10-17 |
| 1154682573 | Keith Phillip Davis | Pharmacist | 8640 Se Causey Ave Apt S202, Happy Valley, OR 97086-8595 | 2012-06-01 |
| 1528184199 | Keith Alan Davis | Chiropractor | 4640 N Francisco Ave, Chicago, IL 60625-3723 | 2007-03-22 |
| 1346315025 | Keith L Davis | Dentist | 100 Chelsea Corners Way Ste 113, Chelsea, AL 35043-8207 | 2006-11-21 |
| 1952488215 | Keith L Davis | Family Medicine | 741 Scholl Rd, Ste A, Mansfield, OH 44907 | 2006-11-01 |
| 1639268089 | Keith Alan Davis | Ophthalmology | 1011 Sylvan Ave Ste C, Modesto, CA 95350-1693 | 2006-10-12 |
| 1699875419 | Keith G Davis | Chiropractor | 722 Front Street, Casselton, ND 58012-3302 | 2006-09-22 |
| 1104849884 | Keith C. Davis | Dentist | 975 N Church St, Spartanburg, SC 29303-4104 | 2006-07-25 |
| Street Address |
4715 CRENSHAW BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90043-1233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689858672 | Dixon Recovery Institute, Inc. | Counselor | 4715 Crenshaw Blvd, 2nd Floor, Los Angeles, CA 90043-1233 | 2007-12-26 |
| 1912249749 | Tracy R Varnado | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2013-03-19 |
| 1285984195 | Stephisha Walton | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2012-09-18 |
| 1720384803 | Ann M Young | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2011-02-07 |
| 1881990968 | Christian A Smith | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2011-02-07 |
| 1700180155 | Dixon Recovery Institute | Case Management | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2010-12-28 |
| 1063715209 | Jose Antonio Rosales | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2010-12-09 |
| 1205139599 | Alyxandria L Kuhn | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2010-12-08 |
| 1679876064 | Cas'mir C Turton | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2010-12-07 |
| 1669775052 | Carlos Lopez | Counselor | 4715 Crenshaw Blvd, Los Angeles, CA 90043-1233 | 2010-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841772209 | Ichizo Yamada | Counselor | 5318 S Crenshaw Blvd., Los Angeles, CA 90043 | 2018-09-02 |
| 1568961613 | Marnelle Mascardo | Counselor | 5318 S. Crenshaw Blvd., Los Angeles, CA 90043 | 2018-02-05 |
| 1700315199 | Positive Imagery Foundation | Prevention Professional | 5906 7th Avenue, Suite 1, Los Angeles, CA 90043 | 2017-06-08 |
| 1770946303 | Toby Lapesarde | Licensed Vocational Nurse | 5300 Angeles Vista Boulevard, Los Angeles, CA 90043 | 2016-03-31 |
| 1134591480 | Coast Wise Solution | Case Management | 2728 54th St, Los Angeles, CA 90043 | 2015-10-27 |
| 1033589155 | Nina Gonzaga | Marriage & Family Therapist | 4401 Crendshaw Blvd, #300, Los Angeles, CA 90043 | 2015-10-01 |
| 1861743189 | Donna M. Tizenor-tate | Counselor | 5300 Angeles Vista Blvd., Los Angeles, CA 90043 | 2012-09-26 |
| 1952657736 | Willie Frank Sibley Jr. | General Practice | 4330 Monteith Dr, Los Angeles, CA 90043 | 2012-07-30 |
| 1639449119 | Nelson M Okeke | Counselor | 8814 S. Western Ave, La, CA 90043 | 2011-12-30 |
| 1578840799 | Economic Services, Incorporated | Exclusive Provider Organization | 5144 Crenshaw Blvd., Los Angeles, CA 90043 | 2011-11-16 |
| Find all providers in zip 90043 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| 1578179941 | Leo Vasquezawarez | Counselor | 470 E 3rd St # Ab, Los Angeles, CA 90013-1629 | 2020-09-21 |
| 1801401963 | Manuel Gambino | Counselor | 11301 Wilshire Blvd Bldg 337, Los Angeles, CA 90073-1003 | 2020-09-14 |
| 1871107219 | Frances Field | Counselor | 3739 Mentone Ave Apt 7, Los Angeles, CA 90034-6444 | 2020-09-02 |
| 1730707985 | Lucia Miguel | Counselor | 1428 W 59th St, Los Angeles, CA 90047-1209 | 2020-07-13 |
| 1821615220 | Sarah Payne | Counselor | 3217 North Eastern Ave, Los Angeles, CA 90032 | 2020-07-01 |
| 1376168070 | Mercedes Elkoff | Counselor | 1745 Warnall Ave, Los Angeles, CA 90024-5358 | 2020-06-09 |
| 1508481201 | Jeanine Ingram | Counselor | 3815 Lockland Dr, Los Angeles, CA 90008-3533 | 2020-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90043 |
Please comment or provide details below to improve the information on MR. KEITH GERARD DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.