Provider Demographics
NPI:1467339713
Name:RICHARDSON, VAJANIQUE (DOULA)
Entity type:Individual
Prefix:
First Name:VAJANIQUE
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 E MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1060
Mailing Address - Country:US
Mailing Address - Phone:626-223-0325
Mailing Address - Fax:
Practice Address - Street 1:292 E MONTANA ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-1060
Practice Address - Country:US
Practice Address - Phone:626-223-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACERTIFICATE374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula