Individual
MR. CARL DERRICK DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1605 EASTLAKE AVE, LOS ANGELES, CA 90033-1009
(323) 226-8826
Mailing address
1475 WYATT CT, SAN DIEGO, CA 92154-4830
(619) 662-2095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/08/2006
Last updated
09/12/2011
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