MEDICARE: MARISTELA AZEVEDO DAVIDS DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		CA

General Provider Information

NPI Number	:	1144053323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISTELA AZEVEDO DAVIDS DOULA

Provider Business Mailing Address
First Line	:	6211 PANAMA AVE APT A
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-5722
Country	:	US
Telephone Number	:	510-807-7538
Fax Number	:

Provider Business Practice Location Address
First Line	:	6211 PANAMA AVE APT A
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-5722
Country	:	US
Telephone Number	:	510-807-7538
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	08/23/2024

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Directions to “ MARISTELA AZEVEDO DAVIDS DOULA” Practice Location

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