Individual
CAROL LYNN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7200 BANCROFT AVE STE 133, OAKLAND, CA 94605-2480
(510) 553-8500
Mailing address
2308 SAINT GEORGE DR, CONCORD, CA 94520-1331
(925) 876-0195
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37421
CA
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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