Healthcare Provider Details

I. General information

NPI: 1063920502
Provider Name (Legal Business Name): ALIYA MOHRE CALER CNM, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 PENNSYLVANIA AVE
SAN FRANCISCO CA
94107-2914
US

IV. Provider business mailing address

524 PENNSYLVANIA AVE
SAN FRANCISCO CA
94107-2914
US

V. Phone/Fax

Practice location:
  • Phone: 206-349-6718
  • Fax:
Mailing address:
  • Phone: 206-349-6718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: