Healthcare Provider Details

I. General information

NPI: 1629158316
Provider Name (Legal Business Name): BIRTHING WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 S MARENGO AVE
PASADENA CA
91101-3113
US

IV. Provider business mailing address

438 S MARENGO AVE
PASADENA CA
91101-3113
US

V. Phone/Fax

Practice location:
  • Phone: 626-683-9015
  • Fax: 626-683-9045
Mailing address:
  • Phone: 626-683-9015
  • Fax: 626-683-9045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: MS. NKEMDILIM NDEFO
Title or Position: GENERAL PARTNER
Credential: CNM
Phone: 626-683-9015