MEDICARE: MRS. FERMY CARMEN HOOD

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	:	1063114304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FERMY CARMEN HOOD

Provider Business Mailing Address
First Line	:	11148 BREINER CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-2309
Country	:	US
Telephone Number	:	951-961-2024
Fax Number	:

Provider Business Practice Location Address
First Line	:	11148 BREINER CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-2309
Country	:	US
Telephone Number	:	951-961-2024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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