Healthcare Provider Details

I. General information

NPI: 1043229263
Provider Name (Legal Business Name): CREATING HARMONY WOMEN'S HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 JOHNSON AVE SUITE #202
SAN LUIS OBISPO CA
93401-4140
US

IV. Provider business mailing address

1941 JOHNSON AVE SUITE #202
SAN LUIS OBISPO CA
93401-4140
US

V. Phone/Fax

Practice location:
  • Phone: 805-548-0033
  • Fax: 805-548-0034
Mailing address:
  • Phone: 805-548-0033
  • Fax: 805-548-0034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA88432
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number7319
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1041
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number430
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1530
License Number StateCA

VIII. Authorized Official

Name: DR. AARON KROMHOUT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-548-0033