Healthcare Provider Details

I. General information

NPI: 1164305827
Provider Name (Legal Business Name): SRIDASI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 S SAINT FRANCIS DR STE D
SANTA FE NM
87505-4053
US

IV. Provider business mailing address

1223 S SAINT FRANCIS DR STE D
SANTA FE NM
87505-4053
US

V. Phone/Fax

Practice location:
  • Phone: 505-310-9358
  • Fax: 505-557-1081
Mailing address:
  • Phone: 505-310-9358
  • Fax: 505-557-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: SUNDAY LAW
Title or Position: OWNER, LICENSED MIDWIFE
Credential: LM, CPM, CLC, CHES
Phone: 505-310-9358