=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134915036
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE LOU OBERLANDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2025
-----------------------------------------------------
Last Update Date | 04/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5533 NOEL DR
-----------------------------------------------------
City | TEMPLE CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91780-2318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-975-0472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5533 NOEL DR
-----------------------------------------------------
City | TEMPLE CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91780-2318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-975-0472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------