Provider Demographics
NPI:1447397203
Name:BEACH CITIES MIDWIFERY & WOMEN'S HEALTH
Entity Type:Organization
Organization Name:BEACH CITIES MIDWIFERY & WOMEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, WHCNP, RN
Authorized Official - Phone:949-661-3101
Mailing Address - Street 1:665 CAMINO DE LOS MARES STE 203A
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2836
Mailing Address - Country:US
Mailing Address - Phone:949-661-3101
Mailing Address - Fax:949-443-5275
Practice Address - Street 1:665 CAMINO DE LOS MARES STE 203A
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2836
Practice Address - Country:US
Practice Address - Phone:949-661-3101
Practice Address - Fax:949-443-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301031176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA301031OtherCALIFORNIA LICENSE NUMBER
CA1430OtherMF, NMW
CA1430OtherMF, NMW