Individual
DAYJAHNAY SHANTAY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1260 MORENA BLVD, SAN DIEGO, CA 92110-2111
(619) 507-8977
Mailing address
1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110-3850
(619) 398-0355
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
02/17/2021
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