Provider Demographics
NPI:1417737065
Name:SO AMAZING DOULA,LLC
Entity Type:Organization
Organization Name:SO AMAZING DOULA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED DOULA/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMETRA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED DOULA
Authorized Official - Phone:213-713-6363
Mailing Address - Street 1:1604 E 124TH ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90222-1102
Mailing Address - Country:US
Mailing Address - Phone:213-713-6363
Mailing Address - Fax:
Practice Address - Street 1:1604 E 124TH ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-1102
Practice Address - Country:US
Practice Address - Phone:213-713-6363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty