=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780520569
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAILY DOULA SUPPORT SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2026
-----------------------------------------------------
Last Update Date | 04/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3800 WATT AVE STE 216D
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95821-2670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-313-7236
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1520 E COVELL BLVD STE 5
-----------------------------------------------------
City | DAVIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95616-1366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-313-7236
-----------------------------------------------------
Fax | 916-313-7236
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | KEVIN JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 279-257-5673
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------