Healthcare Provider Details

I. General information

NPI: 1265121487
Provider Name (Legal Business Name): STEPHANIE KERWIN LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 SEA RIDGE RD
APTOS CA
95003-4364
US

IV. Provider business mailing address

245 SEA RIDGE RD
APTOS CA
95003-4364
US

V. Phone/Fax

Practice location:
  • Phone: 831-818-7875
  • Fax: 831-400-3348
Mailing address:
  • Phone: 831-818-7875
  • Fax: 831-400-3348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number705
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: