Provider Demographics
NPI:1679265375
Name:CARRASQUILLO, PAULA CHRISTINE (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:CHRISTINE
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 SONOMA AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-6329
Mailing Address - Country:US
Mailing Address - Phone:707-543-6700
Mailing Address - Fax:
Practice Address - Street 1:433 SONOMA AVE APT 5
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-6329
Practice Address - Country:US
Practice Address - Phone:707-543-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula