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General NPI Number Information
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NPI Number | 1992058655
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Entity Type | Individual
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Provider Name | JESSICA MASON LEVIN CNM, RN, L.AC., LMT
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Gender | Female
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 12/19/2018
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Provider Practice Location Address
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Address Line | 250 BON AIR RD
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City | GREENBRAE
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State | CA
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Zip | 94904-1702
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Country | US
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Telephone | 503-867-1753
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Fax | 503-867-1753
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Provider Business Mailing Address
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Address Line | 1782 36TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-4115
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Country | US
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Telephone | 503-867-1753
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Fax | 503-867-1753
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NMW235995
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN95171339
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC159731
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 10676
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License Number State | OR
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Taxonomy #5
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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 | NULL
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