MEDICARE: SANTA ROSA MIDWIFERY CENTER

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	261QB0400X	Birthing Clinic/Center

General Provider Information

NPI Number	:	1336576370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA ROSA MIDWIFERY CENTER

Provider Business Mailing Address
First Line	:	4415 SONOMA HWY STE B
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95409-4165
Country	:	US
Telephone Number	:	707-539-1544
Fax Number	:	707-539-0686

Provider Business Practice Location Address
First Line	:	4415 SONOMA HWY STE B
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95409-4165
Country	:	US
Telephone Number	:	707-539-1544
Fax Number	:	707-539-0686

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH POINTER SMITH
Credential	:	CNM
Telephone Number	:	707-539-1544

Provider Enumeration Date	:	10/05/2013
Last Update Date	:	12/04/2023

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