MEDICARE: TONJA MCHENRY BEY DOULA

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		CA

General Provider Information

NPI Number	:	1063128064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONJA MCHENRY BEY DOULA

Provider Business Mailing Address
First Line	:	2087 SAINT EMILION LN
Second Line	:
City	:	SAN JACINTO
State	:	CA
Zip	:	92583-5809
Country	:	US
Telephone Number	:	951-237-7353
Fax Number	:	951-487-6925

Provider Business Practice Location Address
First Line	:	2087 SAINT EMILION LN
Second Line	:
City	:	SAN JACINTO
State	:	CA
Zip	:	92583-5809
Country	:	US
Telephone Number	:	951-237-7353
Fax Number	:	951-487-6925

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

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	01/24/2023

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