Healthcare Provider Details
I. General information
NPI: 1598037053
Provider Name (Legal Business Name): TERESA MARIE NAVA-ANDERSON PHD, CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/30/2012
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 W LA CANADA AVE
MOUNTAIN HOUSE CA
95391-1155
US
IV. Provider business mailing address
700 W LA CANADA AVE
MOUNTAIN HOUSE CA
95391-1155
US
V. Phone/Fax
- Phone: 209-833-7629
- Fax:
- Phone: 209-833-7629
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374J00000X |
| Taxonomy | Doula |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: