MEDICARE: DOULA ON DECK

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	:	1710840426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOULA ON DECK

Provider Business Mailing Address
First Line	:	2950 75TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-2904
Country	:	US
Telephone Number	:	510-717-0941
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 75TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-2904
Country	:	US
Telephone Number	:	510-717-0941
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMAR DENISE JACKSON
Credential	:
Telephone Number	:	510-717-0941

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “DOULA ON DECK ” Practice Location

Language	Start Address	Practice Location

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