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General NPI Number Information
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NPI Number | 1619327137
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Entity Type | Organization
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Legal Business Name | SAN DIEGO COUNTY MIDWIVES
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 15644 POMERADO RD STE 302
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City | POWAY
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State | CA
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Zip | 92064-2455
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Country | US
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Telephone | 858-278-2930
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Fax |
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Provider Business Mailing Address
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Address Line | 275 S WORTHINGTON ST SPC 120
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City | SPRING VALLEY
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State | CA
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Zip | 91977-6344
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Country | US
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Telephone | 619-434-9011
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Fax | 619-434-9199
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GERRI LYNN RYAN
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Credential | LM, CPM
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Telephone | 619-957-0910
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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 | LM 162 & LM 297
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License Number State | CA
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