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Organization

JANE DAVIS LISENCED CLINICAL SOCIAL WORKER PROFESSIONAL PSYCHOTHERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JANE CHRISTINE GRAHAM DAVIS LCSW (PRESIDENT)
(213) 915-4024
Entity
Organization

Contact information

Practice address
732 W 9TH ST, SAN PEDRO, CA 90731-3634
(213) 915-4024
Mailing address
1732 AVIATION BLVD # 122, REDONDO BEACH, CA 90278-2810
(213) 915-4024

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
10/14/2021
Last updated
10/14/2021
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