Provider Demographics
NPI:1790374551
Name:OSOWSKY, JESSICA (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:OSOWSKY
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:OSOWSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SHULMAN
Mailing Address - Street 1:2600 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3827
Mailing Address - Country:US
Mailing Address - Phone:310-721-5308
Mailing Address - Fax:
Practice Address - Street 1:2600 GRANT AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3827
Practice Address - Country:US
Practice Address - Phone:310-721-5308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula