MEDICARE: THE BREEZY DOULA LLC

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

General Provider Information

NPI Number	:	1184330474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BREEZY DOULA LLC

Provider Business Mailing Address
First Line	:	21292 VALEWOOD
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-6461
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21292 VALEWOOD
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-6461
Country	:	US
Telephone Number	:	949-300-0433
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CERTIFIED DOULA
Name	:	BREANA ZACCARO
Credential	:	CD(DONA)
Telephone Number	:	949-300-0433

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	01/30/2023

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Directions to “THE BREEZY DOULA LLC ” Practice Location

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