MEDICARE: MISS DAISHAN MONAE EPPERSON

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	:	1215704838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DAISHAN MONAE EPPERSON

Provider Business Mailing Address
First Line	:	3431 W 67TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-4316
Country	:	US
Telephone Number	:	714-909-8507
Fax Number	:

Provider Business Practice Location Address
First Line	:	3431 W 67TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-4316
Country	:	US
Telephone Number	:	714-909-8507
Fax Number	:

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

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/04/2023

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Directions to “ MISS DAISHAN MONAE EPPERSON ” Practice Location

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