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General NPI Number Information
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NPI Number | 1336967348
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Entity Type | Organization
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Legal Business Name | RISING TIDE MIDWIFERY
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1051 TREASURE LN
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City | ROSEVILLE
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State | CA
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Zip | 95678-1459
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Country | US
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Telephone | 415-300-7329
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Fax |
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Provider Business Mailing Address
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Address Line | 1051 TREASURE LN
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City | ROSEVILLE
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State | CA
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Zip | 95678-1459
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Country | US
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Telephone | 415-300-7329
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SHELTON LIVINGSTON
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Credential | LM, DOULA
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Telephone | 415-300-7329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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