Healthcare Provider Details

I. General information

NPI: 1588427116
Provider Name (Legal Business Name): LOUISE DOULA & FAMILY HEALTH SERVICES L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 FAIRWAY GLEN LN
SAN JOSE CA
95139-1521
US

IV. Provider business mailing address

209 FAIRWAY GLEN LN
SAN JOSE CA
95139-1521
US

V. Phone/Fax

Practice location:
  • Phone: 408-466-9150
  • Fax:
Mailing address:
  • Phone: 408-466-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS TAYLOR LOUISE MILLER
Title or Position: OWNER/FULL SPECTRUM DOULA
Credential: MPH, CD, LEC
Phone: 408-466-9150