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General NPI Number Information
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NPI Number | 1710708474
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Entity Type | Organization
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Legal Business Name | LA MATRIZ BIRTH SERVICES INC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 3633 CAMINO DEL RIO SOUTH STE 206
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City | SAN DIEGO
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State | CA
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Zip | 92108
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Country | US
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Telephone | 408-209-2234
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Fax | 619-761-5825
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Provider Business Mailing Address
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Address Line | 6752 HIBISCUS DR
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City | LEMON GROVE
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State | CA
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Zip | 91945-1316
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Country | US
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Telephone | 408-209-2223
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Fax | 619-761-5825
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Authorized Official
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Title or Position | LICENSED MIDWIFE
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Name | BIANCA V MERCADO
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Credential | LM
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Telephone | 408-209-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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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 |
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License Number State |
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