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General NPI Number Information
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NPI Number | 1679922330
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Entity Type | Organization
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Legal Business Name | BIRTH YOUR WAY
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 12142 BRYANT ST
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City | YUCAIPA
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State | CA
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Zip | 92399-4478
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Country | US
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Telephone | 909-343-8766
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Fax | 909-363-8134
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Provider Business Mailing Address
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Address Line | 12142 BRYANT ST
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City | YUCAIPA
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State | CA
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Zip | 92399-4478
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Country | US
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Telephone | 909-343-8766
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Fax | 909-363-8134
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Authorized Official
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Title or Position | OWNER
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Name | TAMMY STOKES
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Credential | LM, CPM
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Telephone | 909-553-4366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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