MEDICARE: ANDREA PFEFFER CNM

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	367A00000X	Advanced Practice Midwife	1599	CA

General Provider Information

NPI Number	:	1770533069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA PFEFFER CNM

Provider Business Mailing Address
First Line	:	350 30TH ST
Second Line	:	SUITE 205
City	:	OAKLAND
State	:	CA
Zip	:	94609
Country	:	US
Telephone Number	:	510-444-0790
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 30TH ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94609-3425
Country	:	US
Telephone Number	:	510-444-0790
Fax Number	:

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/16/2007

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