MEDICARE: JENNIFER MEDILLA BECKER

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	:	1558215525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MEDILLA BECKER

Provider Business Mailing Address
First Line	:	629 27TH ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-3108
Country	:	US
Telephone Number	:	360-388-6165
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 27TH ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-3108
Country	:	US
Telephone Number	:	360-388-6165
Fax Number	:

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

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	02/25/2026

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