CRISTINE DAVIS (NPI# 1356562748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356562748 |
| Entity Type | Individual |
| Full Name | CRISTINE DAVIS |
| Practice Address |
10171 Comerate Rd Grass Valley CA 95949-9058 |
| Mailing Address |
714 W Main St Grass Valley CA 95945-6410 |
| Practice Telephone | 5302688310 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
10171 COMERATE RD |
| City | GRASS VALLEY |
| State | CA |
| Zip Code | 95949-9058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942621461 | Tamara Renee Pierson | Residential Treatment Facility, Emotionally Disturbed Children | 10171 Comerate Rd, Grass Valley, CA 95945 | 2013-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215280649 | John Kingsley Pollard IIi | Chiropractor | 10110 Alta Sierra Drive, Suite A, Grass Valley, CA 95949 | 2012-10-23 |
| 1083813455 | Carolyn Sue Stewart | Registered Nurse | 13397 Mccarter Way, Grass Valley, CA 95949 | 2007-07-16 |
| 1487859419 | Susanne T Bock | Chiropractor | 10370 King Way, Grass Valley, CA 95949 | 2007-06-19 |
| 1891917365 | Charis Youth Center | Residential Treatment Facility, Emotionally Disturbed Children | 17036 Bissell Place, Grass Valley, CA 95949 | 2007-05-03 |
| 1093856510 | John H. Stewart | Marriage & Family Therapist | 908 Taylorville Rd., Ste. 206, Grass Valley, CA 95949 | 2007-02-08 |
| 1427196245 | Nancy Kathleen Rarick | Marriage & Family Therapist | 10055 Wolf Rd Ste 4, Grass Valley, CA 95949 | 2007-02-02 |
| 1184726432 | Kathleen Brady | Chiropractor | 10110 Alta Sierra Dr., Suite A, Grass Valley, CA 95949 | 2006-09-05 |
| 1700997681 | Gayle M Crough | Nurse Practitioner | 10058 Wolf Road, Grass Valley, CA 95949 | 2006-08-31 |
| 1356451017 | Raleys Inc | Pharmacy | 692a Freeman Lane, Grass Valley, CA 95949 | 2006-08-30 |
| 1013985340 | Walter Scott Miller | Specialist | 10042 Wolf Road, Suite A, Grass Valley, CA 95949 | 2006-03-11 |
| Find all providers in zip 95949 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740611615 | Jarrett M Weiss | Residential Treatment Facility, Emotionally Disturbed Children | 714 W. Main Street, Grass Valley, CA 95945 | 2013-12-03 |
| 1669802732 | Nicole Marie Sullivan | Residential Treatment Facility, Emotionally Disturbed Children | 714 W Main Street, Grass Valley, CA 95945 | 2013-11-26 |
| 1316377369 | Michelene Arielle-nicole Stringer | Residential Treatment Facility, Emotionally Disturbed Children | 714 West Main Street, Grass Valley, CA 95945 | 2013-11-12 |
| 1497907075 | Rick Edward Beberg | Residential Treatment Facility, Emotionally Disturbed Children | 714 West St., Grass Valley, CA 95945 | 2008-10-15 |
| 1932321221 | Charis Youth Center | Residential Treatment Facility, Emotionally Disturbed Children | 13668 Auburn Rd, Grass Valley, CA 95949-8760 | 2007-05-03 |
| 1083836472 | Deborah Joy Gilcrest | Residential Treatment Facility, Emotionally Disturbed Children | 714 W. Main St., Grass Valley, CA 95945 | 2007-05-03 |
| 1891917365 | Charis Youth Center | Residential Treatment Facility, Emotionally Disturbed Children | 17036 Bissell Place, Grass Valley, CA 95949 | 2007-05-03 |
| 1659593101 | Charis Youth Center | Residential Treatment Facility, Emotionally Disturbed Children | 12875 Rattlesnake Rd, Grass Valley, CA 95945 | 2007-05-03 |
| 1104047588 | Jeanie Lyn Ibbotson | Residential Treatment Facility, Emotionally Disturbed Children | 11855 Slow Poke Ln, Grass Valley, CA 95945-8417 | 2007-05-01 |
| 1821175258 | Charis Youth Center | Residential Treatment Facility, Emotionally Disturbed Children | 714 W Main St, Grass Valley, CA 95945-6410 | 2006-11-01 |
| Find all providers in GRASS VALLEY | ||||
| City | GRASS VALLEY |
| Zip Code | 95949 |
Please comment or provide details below to improve the information on CRISTINE DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.