Provider Demographics
NPI:1477974822
Name:HOWARD, SARA SHIRRELL (LM, CPM)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SHIRRELL
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3621
Mailing Address - Country:US
Mailing Address - Phone:818-625-1574
Mailing Address - Fax:
Practice Address - Street 1:645 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3621
Practice Address - Country:US
Practice Address - Phone:818-625-1574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALICENSED MIDWIFE 385OtherCALIFORNIA