1. Home
  2. Directory
  3. California
  4. Anaheim
  5. Counselor
  6. NPI Profile

JACQUELINE DAVIS
NPI 1720782477
Counselor in Anaheim, CA

Active since March 28, 2023PECOS EnrolledAccepts Medicare Assignment
222 S HARBOR BLVD STE 400, ANAHEIM, CA 92805(714) 517-6300 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 11, 2026, Dec 10, 2024, Dec 9, 2023 and 1 more (4 updates tracked since 2023).

About Jacqueline Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE DAVIS (NPI 1720782477) is an individual counselor in Anaheim, California, licensed in California (LPCC18167) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1720782477
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameJACQUELINE DAVIS
Location Address222 S HARBOR BLVD STE 400Anaheim, CA 92805-3743
Mailing Address2035 E Ball Rd Ste 200Anaheim, CA 92806-5157 · (714) 517-6333
Phone(714) 517-6300
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 28, 2023
Last NPPES UpdateMarch 11, 20264 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1720782477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in CA · LPCC18167
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
222 S HARBOR BLVD STE 400, Anaheim, CA 92805
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Davis is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971098765
PECOS Enrollment IDI20251218003993
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHELSEA ELIZABETH NUNN
Social Worker (Clinical)
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
ELANA ELLEN RANDOL LCSW
Social Worker (Clinical)
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
COUNTY OF ORANGE
Clinic/Center (Adult Mental Health)
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
MISS JENNIE ISAURA PORTILLO
Counselor
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
JENNIFER PAULENE GARCES
Registered Nurse
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
MRS. RACHELLE SALDANA SUPPIPHATVONG
Social Worker (Clinical)
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
JULIE NGO
Social Worker
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300
ERIKA FIELDS
Student in an Organized Health Care Education/Training Program
222 S HARBOR BLVD STE 400
ANAHEIM, CA 92805
Orange County (714) 517-6300

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 Jacqueline Davis's NPI number?

The NPI number for Jacqueline Davis is 1720782477. It was assigned to this individual provider in the NPPES registry on March 28, 2023.

Where is Jacqueline Davis located?

Jacqueline Davis practices at 222 S Harbor Blvd Ste 400, Anaheim, CA 92805. The listed phone number is (714) 517-6300.

What is Jacqueline Davis's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Jacqueline Davis enrolled in Medicare?

Yes. Jacqueline Davis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacqueline Davis was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.