Provider Demographics
NPI:1174356117
Name:DAVIS, SAKINAH
Entity type:Individual
Prefix:
First Name:SAKINAH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 MONTICELLO ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1533
Mailing Address - Country:US
Mailing Address - Phone:412-532-9443
Mailing Address - Fax:
Practice Address - Street 1:7300 MONTICELLO ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1533
Practice Address - Country:US
Practice Address - Phone:412-532-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WH0202X
PACT-175967225700000X, 251C00000X, 253Z00000X, 373H00000X, 174H00000X
CT-1759673747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171WH0202XOther Service ProvidersContractorHome Modifications
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
31193422513334OtherCITY OF PITTSBURGH ID TAX ACCOUNT NUMBER
PA536961-2023-09-SBOtherCOMMONWEALTH OF PENNSYLVANIA SMALL BUSINESS CONTRACTING PROGRAM