| Doctor Name: | DR. STEPHEN GLEN DAVIS |
| NPI Number: | 1063892164 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PSY25207 |
| Business Practice Address: | 24511 W Jayne Ave Coalinga, CA - 932109503 |
| Business Phone Number: | 5599348265 |
| Business Fax Number: | |
| Mailing Address: | Po Box 810, LEMOORE |
| State: | CA |
| Postal Code: | 932450810 |
| Phone Number: | 5599606988 |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2015 |
| NPI Last Update Date: | 06/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | PSY25207 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |