Healthcare Provider Details

I. General information

NPI: 1194469213
Provider Name (Legal Business Name): NEW MOTHER, NEW BABY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 05/08/2022
Certification Date: 05/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3093 BROADWAY UNIT 363
OAKLAND CA
94611-5785
US

IV. Provider business mailing address

3093 BROADWAY UNIT 363
OAKLAND CA
94611-5785
US

V. Phone/Fax

Practice location:
  • Phone: 954-802-8771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE BROWN
Title or Position: OWNER
Credential: RN
Phone: 954-802-8771