Provider Demographics
NPI:1639630346
Name:TARVER, EMUNAH ELAYLA MEYER (LM)
Entity Type:Individual
Prefix:
First Name:EMUNAH
Middle Name:ELAYLA MEYER
Last Name:TARVER
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:LOUISE
Other - Last Name:TARVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1177 KEITH AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1606
Mailing Address - Country:US
Mailing Address - Phone:510-459-3938
Mailing Address - Fax:
Practice Address - Street 1:1177 KEITH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94708-1606
Practice Address - Country:US
Practice Address - Phone:510-459-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM566176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife