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General NPI Number Information
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NPI Number | 1871258038
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Entity Type | Organization
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Legal Business Name | MANZANITA MIDWIFERY
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 191 CARRISA HWY
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City | SANTA MARGARITA
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State | CA
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Zip | 93453-9755
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Country | US
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Telephone | 805-458-2611
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Fax | 805-856-0391
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Provider Business Mailing Address
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Address Line | 191 CARRISA HWY
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City | SANTA MARGARITA
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State | CA
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Zip | 93453-9755
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Country | US
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Telephone | 805-458-2611
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Fax | 805-856-0391
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Authorized Official
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Title or Position | DIRECTOR
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Name | JENNIFER OQUENDO
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Credential | LM, CPM, PHD
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Telephone | 805-458-2611
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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 |
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License Number State |
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