=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164305827
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SRIDASI LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2025
-----------------------------------------------------
Last Update Date | 08/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1223 S SAINT FRANCIS DR STE D
-----------------------------------------------------
City | SANTA FE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87505-4053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-310-9358
-----------------------------------------------------
Fax | 505-557-1081
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1223 S SAINT FRANCIS DR STE D
-----------------------------------------------------
City | SANTA FE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87505-4053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-310-9358
-----------------------------------------------------
Fax | 505-557-1081
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, LICENSED MIDWIFE
-----------------------------------------------------
Name | SUNDAY LAW
-----------------------------------------------------
Credential | LM, CPM, CLC, CHES
-----------------------------------------------------
Telephone | 505-310-9358
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174N00000X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Non-RN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------