Individual
LISA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
120 TRIDENT CT, VALLEJO, CA 94591-7741
(510) 862-9134
Mailing address
120 TRIDENT CT, VALLEJO, CA 94591-7741
(510) 862-9134
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CNM05085
CA
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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