Healthcare Provider Details

I. General information

NPI: 1861973729
Provider Name (Legal Business Name): JULIA E UNDERWOOD LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 12/18/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335-115 E. COLORADO BLVD #339
PASADENA CA
91107
US

IV. Provider business mailing address

2335-115 E. COLORADO BLVD #339
PASADENA CA
91107
US

V. Phone/Fax

Practice location:
  • Phone: 626-216-8665
  • Fax:
Mailing address:
  • Phone: 626-216-8665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number728
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: