| Doctor Name: | JILLIAN DIANE DAVIDSON |
| NPI Number: | 1891120952 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 633004 |
| Business Practice Address: | 441 N Main St Alturas, CA - 961013457 |
| Business Phone Number: | 5302336311 |
| Business Fax Number: | 5302336339 |
| Mailing Address: | 441 N Main St, ALTURAS |
| State: | CA |
| Postal Code: | 961013457 |
| Phone Number: | 5302336311 |
| Fax Number: | 5302336339 |
| NPI Enumeration Date: | 09/09/2013 |
| NPI Last Update Date: | 09/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 633004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |