Healthcare Provider Details

I. General information

NPI: 1568722791
Provider Name (Legal Business Name): MOTHER TO MOTHER MIDWIFERY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 HOWARD AVE
SAN DIEGO CA
92103-2507
US

IV. Provider business mailing address

1816 HOWARD AVE
SAN DIEGO CA
92103-2507
US

V. Phone/Fax

Practice location:
  • Phone: 619-220-8189
  • Fax: 619-220-8197
Mailing address:
  • Phone: 619-220-8189
  • Fax: 619-220-8197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: SUNSHINE CHRISPEELS
Title or Position: LM/OWNER
Credential:
Phone: 619-220-8189