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General NPI Number Information
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NPI Number | 1962895797
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Entity Type | Individual
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Provider Name | LAILI FALATOONZADEH RN, CNM, WHNP
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Gender | Female
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 333 LAWS AVE
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City | UKIAH
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State | CA
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Zip | 95482-6540
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Country | US
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Telephone | 707-468-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 31723 HIGHWAY 128
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City | CLOVERDALE
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State | CA
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Zip | 95425-9445
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Country | US
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Telephone | 909-260-6101
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95099659
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 236003
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95010469
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License Number State | CA
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