MEDICARE: MS. SHERINA CRISWELL DOULA

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	:	1477327542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERINA CRISWELL DOULA

Provider Business Mailing Address
First Line	:	3747 CLAYTON RD
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94521-2555
Country	:	US
Telephone Number	:	415-504-5786
Fax Number	:

Provider Business Practice Location Address
First Line	:	3747 CLAYTON RD
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94521-2555
Country	:	US
Telephone Number	:	415-504-5786
Fax Number	:

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

Provider Enumeration Date	:	11/09/2023
Last Update Date	:	11/09/2023

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