Healthcare Provider Details

I. General information

NPI: 1174403679
Provider Name (Legal Business Name): CLAIRE DONOVAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

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

130 LA CASA VIA STE 112
WALNUT CREEK CA
94598-3083
US

IV. Provider business mailing address

1505 4TH ST APT 809
SAN FRANCISCO CA
94158-2278
US

V. Phone/Fax

Practice location:
  • Phone: 925-301-9875
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: