MEDICARE: MOMENT OF MOTHERHOOD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1003743964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOMENT OF MOTHERHOOD LLC

Provider Business Mailing Address
First Line	:	1135 FLAMINGO AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92021-3323
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 FLAMINGO AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92021-3323
Country	:	US
Telephone Number	:	619-402-7834
Fax Number	:

Authorized Official
Title or Position	:	OWNER/BIRTH DOULA
Name	:	LILLIAN POTTS
Credential	:
Telephone Number	:	619-402-7834

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “MOMENT OF MOTHERHOOD LLC ” Practice Location

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