Healthcare Provider Details

I. General information

NPI: 1003743964
Provider Name (Legal Business Name): MOMENT OF MOTHERHOOD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 FLAMINGO AVE
EL CAJON CA
92021-3323
US

IV. Provider business mailing address

1135 FLAMINGO AVE
EL CAJON CA
92021-3323
US

V. Phone/Fax

Practice location:
  • Phone: 619-402-7834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LILLIAN POTTS
Title or Position: OWNER/BIRTH DOULA
Credential:
Phone: 619-402-7834