Healthcare Provider Details

I. General information

NPI: 1710840426
Provider Name (Legal Business Name): DOULA ON DECK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 75TH AVE
OAKLAND CA
94605-2904
US

IV. Provider business mailing address

2950 75TH AVE
OAKLAND CA
94605-2904
US

V. Phone/Fax

Practice location:
  • Phone: 510-717-0941
  • Fax:
Mailing address:
  • Phone: 510-717-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: TAMAR DENISE JACKSON
Title or Position: OWNER
Credential:
Phone: 510-717-0941