Healthcare Provider Details

I. General information

NPI: 1528933678
Provider Name (Legal Business Name): SOCAL DOULA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35851 LOURDES DR
WINCHESTER CA
92596-9148
US

IV. Provider business mailing address

35851 LOURDES DR
WINCHESTER CA
92596-9148
US

V. Phone/Fax

Practice location:
  • Phone: 562-754-1320
  • Fax:
Mailing address:
  • Phone: 562-754-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAYNA CHESSMAN
Title or Position: OWNER
Credential: DOULA
Phone: 562-754-1320