Provider Demographics
NPI:1265309264
Name:DR. DAVINA INC.
Entity type:Organization
Organization Name:DR. DAVINA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICK
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:650-366-4299
Mailing Address - Street 1:499 SEAPORT CT STE 101
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2782
Mailing Address - Country:US
Mailing Address - Phone:650-366-4299
Mailing Address - Fax:
Practice Address - Street 1:499 SEAPORT CT STE 101
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2782
Practice Address - Country:US
Practice Address - Phone:650-366-4299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy