=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750246443
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAHOE DOULA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2025
-----------------------------------------------------
Last Update Date | 12/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10653 PINE CONE DR
-----------------------------------------------------
City | TRUCKEE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96161-3127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-989-8506
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10653 PINE CONE DR
-----------------------------------------------------
City | TRUCKEE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96161-3127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANDREA M SCHWARTZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 434-989-8506
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------