Healthcare Provider Details

I. General information

NPI: 1891457909
Provider Name (Legal Business Name): MARIPOSA BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 ZION ST
NEVADA CITY CA
95959-2923
US

IV. Provider business mailing address

830 ZION ST
NEVADA CITY CA
95959-2923
US

V. Phone/Fax

Practice location:
  • Phone: 530-264-7174
  • Fax: 530-362-4642
Mailing address:
  • Phone: 530-264-7174
  • Fax: 530-362-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEAH LAROCHE-PAPERNO
Title or Position: LICENSED MIDWIFE/CFO
Credential: LM
Phone: 706-949-0559