Healthcare Provider Details

I. General information

NPI: 1669167029
Provider Name (Legal Business Name): ASHLEY RENEE SAYERS IBCLC, DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY RENEE KIDWELL

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W DEVONSHIRE AVE APT H193
HEMET CA
92545-2374
US

IV. Provider business mailing address

3800 W DEVONSHIRE AVE APT H193
HEMET CA
92545-2374
US

V. Phone/Fax

Practice location:
  • Phone: 360-551-5136
  • Fax:
Mailing address:
  • Phone: 360-551-5136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-310226
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: