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General NPI Number Information
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NPI Number | 1396124954
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Entity Type | Individual
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Provider Name | DEANNA MICHELLE MULDER LM, CPM
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Gender | Female
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 789 ESTUDILLO AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-5109
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Country | US
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Telephone | 510-421-6180
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Fax |
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Provider Business Mailing Address
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Address Line | 789 ESTUDILLO AVENUE
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City | SAN LEANDRO
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State | CA
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Zip | 94577
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Country | US
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Telephone | 510-421-6180
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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 | LM439
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License Number State | CA
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