MEDICARE: JOHNNA BLOCKER POSTPARTUM 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

General Provider Information

NPI Number	:	1629880562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNNA BLOCKER POSTPARTUM DOULA

Provider Business Mailing Address
First Line	:	1077 W 38TH
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-1168
Country	:	US
Telephone Number	:	323-495-9477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1077 W 38TH
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-1168
Country	:	US
Telephone Number	:	323-495-9477
Fax Number	:

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

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	02/09/2025

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