Provider Demographics
NPI:1225703663
Name:KINDREDSPACELA
Entity Type:Organization
Organization Name:KINDREDSPACELA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR/MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DURDIN
Authorized Official - Suffix:
Authorized Official - Credentials:LM,CPM
Authorized Official - Phone:310-986-4996
Mailing Address - Street 1:2610 SOUTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-4528
Mailing Address - Country:US
Mailing Address - Phone:323-381-5511
Mailing Address - Fax:
Practice Address - Street 1:2610 SOUTHWEST DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-4528
Practice Address - Country:US
Practice Address - Phone:323-381-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty