MEDICARE: BLISSFUL BABY DOULA SERVICES

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	:	1871282046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLISSFUL BABY DOULA SERVICES

Provider Business Mailing Address
First Line	:	1748 1/2 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6036
Country	:	US
Telephone Number	:	323-633-4577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1748 1/2 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6036
Country	:	US
Telephone Number	:	323-633-4577
Fax Number	:

Authorized Official
Title or Position	:	DOULA/ BUSINESS OWNER
Name	:	CHARLYNE CATHERINE ALVARADO
Credential	:
Telephone Number	:	323-633-4577

Provider Enumeration Date	:	05/03/2023
Last Update Date	:	05/03/2023

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