MEDICARE: THE NURTURED PATH LLC

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	:	1861377293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NURTURED PATH LLC

Provider Business Mailing Address
First Line	:	5642 DARIEN CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-2315
Country	:	US
Telephone Number	:	909-767-0951
Fax Number	:

Provider Business Practice Location Address
First Line	:	5642 DARIEN CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-2315
Country	:	US
Telephone Number	:	909-767-0951
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KRISTYNNE RODRIGUEZ
Credential	:
Telephone Number	:	909-767-0951

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/06/2025

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Directions to “THE NURTURED PATH LLC ” Practice Location

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