=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922807106
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNKISSED DOULA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2025
-----------------------------------------------------
Last Update Date | 03/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 636 N HILL PL APT 306B
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90012-2291
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-404-4222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 611 WILSHIRE BLVD STE 900
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90017-2905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-404-4222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOULA
-----------------------------------------------------
Name | ANTOINETTE JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 323-404-4221
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------