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General NPI Number Information
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NPI Number | 1245426063
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Entity Type | Individual
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Provider Name | JAYVON DUPREE MUHAMMAD L.M.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2007
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 630 DRAKE AVE
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City | SAUSALITO
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State | CA
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Zip | 94965-1107
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Country | US
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Telephone | 415-583-7436
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Fax |
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Provider Business Mailing Address
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Address Line | 826 YORK ST
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City | VALLEJO
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State | CA
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Zip | 94590-6253
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Country | US
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Telephone | 415-583-7436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | LM197
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License Number State | CA
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