Healthcare Provider Details

I. General information

NPI: 1770490856
Provider Name (Legal Business Name): BELLEVIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5812 BURNHAM AVE
BUENA PARK CA
90621-1820
US

IV. Provider business mailing address

15068 ROSECRANS AVE # 284
LA MIRADA CA
90638-4740
US

V. Phone/Fax

Practice location:
  • Phone: 818-593-9554
  • Fax:
Mailing address:
  • Phone: 714-868-6892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA EKREBE
Title or Position: CEO
Credential: RN
Phone: 714-868-6892