Individual
TANYA LYNN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 S HALE AVE SPC 54, ESCONDIDO, CA 92029-2177
(858) 729-8295
Mailing address
870 SAN MATEO CIR, HEMET, CA 92543-6828
(909) 497-0356
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B5335681
DRIVER LICENSE
CA
Enumeration date
10/02/2024
Last updated
10/02/2024
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