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General NPI Number Information
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NPI Number | 1982914487
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Entity Type | Individual
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Provider Name | CASSAUNDRA RENEA JAH PHD, LM, CPM, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 176 PINON TRL
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City | CEDAR CREST
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State | NM
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Zip | 87008-9457
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Country | US
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Telephone | 505-407-4378
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Fax |
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Provider Business Mailing Address
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Address Line | 7708 LAZY LN
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City | AUSTIN
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State | TX
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Zip | 78757-1414
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Country | US
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Telephone | 808-283-5373
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 11065708
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 10076R
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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