Healthcare Provider Details

I. General information

NPI: 1154234748
Provider Name (Legal Business Name): AMY ISABEL OGBONNA DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 EL CAMINO REAL # 307A
SOUTH SAN FRANCISCO CA
94080-4446
US

IV. Provider business mailing address

988 EL CAMINO REAL APT 314
SOUTH SAN FRANCISCO CA
94080-3254
US

V. Phone/Fax

Practice location:
  • Phone: 650-826-7130
  • Fax: 202-968-0184
Mailing address:
  • Phone: 650-826-7130
  • Fax: 202-968-0184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: