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General NPI Number Information
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NPI Number | 1821506866
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Entity Type | Individual
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Provider Name | MADISON JAY BEAL CNM
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Gender | Female
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 5385 FRANKLIN BLVD STE A-D
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City | SACRAMENTO
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State | CA
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Zip | 95820-4717
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Country | US
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Telephone | 916-452-7305
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Fax | 916-452-9753
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Provider Business Mailing Address
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Address Line | 1691 THE ALAMEDA
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City | SAN JOSE
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State | CA
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Zip | 95126-2203
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Country | US
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Telephone | 408-795-3619
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 235938
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License Number State | CA
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