Provider Demographics
NPI:1669265690
Name:DAVIS, NAELANI JUSTICE-SERENITY
Entity type:Individual
Prefix:
First Name:NAELANI
Middle Name:JUSTICE-SERENITY
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 1:37458 BRISTOL CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-6226
Mailing Address - Country:US
Mailing Address - Phone:661-583-9042
Mailing Address - Fax:
Practice Address - Street 1:41769 11TH ST W
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1418
Practice Address - Country:US
Practice Address - Phone:661-947-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician