Provider Demographics
NPI:1407405673
Name:RAY, MICAELA CLAIRE (CNM)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:CLAIRE
Last Name:RAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20948 TULSA ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1564
Mailing Address - Country:US
Mailing Address - Phone:818-939-8357
Mailing Address - Fax:
Practice Address - Street 1:23548 LYONS AVE STE B
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-5782
Practice Address - Country:US
Practice Address - Phone:661-254-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95154009163WM0102X
CA236057176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn