Provider Demographics
NPI:1790547636
Name:SANTOS TAVERAS, ANA P (DOULA)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:P
Last Name:SANTOS TAVERAS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOULA
Mailing Address - Street 1:28 GREENVILLE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-2410
Mailing Address - Country:US
Mailing Address - Phone:617-606-0432
Mailing Address - Fax:
Practice Address - Street 1:28 GREENVILLE ST APT 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-2410
Practice Address - Country:US
Practice Address - Phone:617-606-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS73205035374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula