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Organization

MIND DOJO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEVAUGHN DAVIS (OWNER)
(951) 477-7745
Entity
Organization

Contact information

Practice address
600 W BROADWAY STE 700, SAN DIEGO, CA 92101-3370
(951) 477-7745
Mailing address
600 W BROADWAY STE 700, SAN DIEGO, CA 92101-3370
(951) 477-7745

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
11/28/2022
Last updated
11/28/2022
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