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General NPI Number Information
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NPI Number | 1255859328
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Entity Type | Individual
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Provider Name | TIA YVETTE THOMPSON CNM
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Gender | Female
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 6600 BRUCEVILLE RD
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City | SACRAMENTO
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State | CA
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Zip | 95823-4671
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Country | US
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Telephone | 916-688-2569
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 L ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-3805
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Country | US
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Telephone | 916-912-2186
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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 | 235833
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License Number State | CA
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