MR. RANDALL B DAVIS LMFT
NPI 1124054119
Marriage & Family Therapist in Corona, CA
About Mr. Randall B Davis Lmft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. RANDALL B DAVIS LMFT (NPI 1124054119) is an individual marriage & family therapist in Corona, California, licensed in California (19383) and active in the NPI registry since June 2006. He has opted out of Medicare through December 21, 2026 and maintains a secondary practice location in Irvine.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mr. Randall B Davis Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 21, 2024 through December 21, 2026.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CORONA, CA 92881
CORONA, CA 92881
CORONA, CA 92881
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Randall Davis's NPI number?
The NPI number for Randall Davis is 1124054119. It was assigned to this individual provider in the NPPES registry on June 23, 2006.
Where is Randall Davis located?
Randall Davis practices at 1101 California Ave Ste 100, Corona, CA 92881. The listed phone number is (951) 736-8193.
What is Randall Davis's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Randall Davis enrolled in Medicare?
No. Randall Davis has opted out of Medicare through December 21, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Randall Davis was last updated on December 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Randall B Davis, LMFT · NPI 1124054119
Marriage & Family Therapist provider in Corona, California. Individual provider, active in the CMS NPPES registry since June 23, 2006.
## Identity
- **NPI:** 1124054119 (Entity type: Individual)
- **Enumerated:** June 23, 2006
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 19383 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1101 CALIFORNIA AVE STE 100, Corona, CA 92881-6472
- **Phone:** (951) 736-8193 · **Fax:** (888) 388-0170
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through December 21, 2026); services are provided under private contract
## Record status
- **NPPES last updated:** December 12, 2018
- **Other identifiers:** Other 19383 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1124054119) · Data from the CMS NPPES public registry.