Provider Demographics
NPI:1790028009
Name:CHARMATZ, HEATHER (DOULA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CHARMATZ
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 1:2233 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1226
Mailing Address - Country:US
Mailing Address - Phone:415-830-7501
Mailing Address - Fax:
Practice Address - Street 1:2233 LAKE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1226
Practice Address - Country:US
Practice Address - Phone:415-830-7501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
CAB9978683374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790028009OtherNPI NUMBER