Healthcare Provider Details

I. General information

NPI: 1124872114
Provider Name (Legal Business Name): MATERNITY MATTERS EDUCATION AND COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11844 CENTRALIA ST
LAKEWOOD CA
90715-1434
US

IV. Provider business mailing address

11138 DEL AMO BLVD STE 201
LAKEWOOD CA
90715-1103
US

V. Phone/Fax

Practice location:
  • Phone: 562-302-1105
  • Fax:
Mailing address:
  • Phone: 562-302-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAVANNE BROOKS
Title or Position: CFO
Credential: MSN, FNP-C
Phone: 562-302-1105