Healthcare Provider Details

I. General information

NPI: 1508256389
Provider Name (Legal Business Name): A TIME TO BE BORN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 T ST
FRESNO CA
93721-1412
US

IV. Provider business mailing address

4670 N 2ND ST
FRESNO CA
93726-1632
US

V. Phone/Fax

Practice location:
  • Phone: 559-374-5874
  • Fax:
Mailing address:
  • Phone: 559-285-5343
  • Fax: 559-221-7579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DETRAH ELLEN HELE
Title or Position: OWNER
Credential: LM
Phone: 559-285-5343