Healthcare Provider Details

I. General information

NPI: 1952281487
Provider Name (Legal Business Name): WHOLISTIC BIRTH AND WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 COCHRAN ST STE 102
SIMI VALLEY CA
93063-2500
US

IV. Provider business mailing address

3355 COCHRAN ST STE 102
SIMI VALLEY CA
93063-2500
US

V. Phone/Fax

Practice location:
  • Phone: 661-347-8342
  • Fax:
Mailing address:
  • Phone: 661-347-8342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: ANDREA PONGO
Title or Position: MIDWIFE
Credential: LM CPM
Phone: 661-347-8342