Provider Demographics
NPI:1760115687
Name:LA CEIBA MIDWIFERY
Entity Type:Organization
Organization Name:LA CEIBA MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:CPM,LM
Authorized Official - Phone:213-909-6929
Mailing Address - Street 1:630 AROMITAS RD
Mailing Address - Street 2:
Mailing Address - City:AROMAS
Mailing Address - State:CA
Mailing Address - Zip Code:95004-9691
Mailing Address - Country:US
Mailing Address - Phone:213-909-6929
Mailing Address - Fax:
Practice Address - Street 1:3181 OAKGATE WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3047
Practice Address - Country:US
Practice Address - Phone:213-909-6929
Practice Address - Fax:213-566-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing