Provider Demographics
NPI:1033241021
Name:OSBORN, ALISON (LM)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:OSBORN
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-0453
Mailing Address - Country:US
Mailing Address - Phone:530-477-1154
Mailing Address - Fax:530-272-4253
Practice Address - Street 1:117 WOOD ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-6228
Practice Address - Country:US
Practice Address - Phone:430-477-1154
Practice Address - Fax:530-272-4253
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM16176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife