Healthcare Provider Details

I. General information

NPI: 1720351018
Provider Name (Legal Business Name): JAIME ALLISON SHAPIRO LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 BENNINGTON ST
SAN FRANCISCO CA
94110-5513
US

IV. Provider business mailing address

203 BENNINGTON ST
SAN FRANCISCO CA
94110-5513
US

V. Phone/Fax

Practice location:
  • Phone: 415-810-8041
  • Fax: 415-373-9459
Mailing address:
  • Phone: 415-810-8041
  • Fax: 415-373-9459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: