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General NPI Number Information
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NPI Number | 1407405673
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Entity Type | Individual
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Provider Name | MICAELA CLAIRE RAY CNM
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Gender | Female
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 23548 LYONS AVE STE B
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City | NEWHALL
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State | CA
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Zip | 91321-5782
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Country | US
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Telephone | 661-254-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 20948 TULSA ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-1564
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Country | US
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Telephone | 818-939-8357
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 95154009
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 236057
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License Number State | CA
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