Healthcare Provider Details

I. General information

NPI: 1770841843
Provider Name (Legal Business Name): PACIFICA FAMILY MATERNITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 TELEGRAPH AVE
BERKELEY CA
94705-1984
US

IV. Provider business mailing address

3101 TELEGRAPH AVE
BERKELEY CA
94705-1984
US

V. Phone/Fax

Practice location:
  • Phone: 510-299-3760
  • Fax: 510-299-3760
Mailing address:
  • Phone: 510-299-3760
  • Fax: 510-299-3760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: CINDY HAAG
Title or Position: FOUNDER MIDWIFE
Credential:
Phone: 510-299-3760