=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528903523
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAVENDER PETALS DOULA SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2026
-----------------------------------------------------
Last Update Date | 04/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 45358 21ST ST W
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93536-6718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-480-6454
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2064 W AVENUE J # 364
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93536-5913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-480-6554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | KANIKKA L DADD
-----------------------------------------------------
Credential | N/A
-----------------------------------------------------
Telephone | 661-480-6454
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------