MEDICARE: JAMES CARLEY

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	:	1457119091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES CARLEY

Provider Business Mailing Address
First Line	:	6540 WENTWORTH SPRINGS RD
Second Line	:
City	:	GEORGETOWN
State	:	CA
Zip	:	95634-9701
Country	:	US
Telephone Number	:	310-972-1949
Fax Number	:

Provider Business Practice Location Address
First Line	:	6530 WENTWORTH SPRINGS RD
Second Line	:
City	:	GEORGETOWN
State	:	CA
Zip	:	95634-9701
Country	:	US
Telephone Number	:	530-333-8320
Fax Number	:

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

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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Directions to “ JAMES CARLEY ” Practice Location

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