MEDICARE: BLOSSOM BIRTH & GROW

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	175M00000X	Lay Midwife
2	374J00000X	Doula

General Provider Information

NPI Number	:	1336957331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOSSOM BIRTH & GROW

Provider Business Mailing Address
First Line	:	8722 RAMSGATE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8722 RAMSGATE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4608
Country	:	US
Telephone Number	:	714-909-8507
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOULA/MIDWIFE ASSIST
Name	:	DAISHAN MONAE EPPERSON
Credential	:
Telephone Number	:	714-909-8507

Provider Enumeration Date	:	12/21/2024
Last Update Date	:	12/07/2025

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Directions to “BLOSSOM BIRTH & GROW ” Practice Location

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