Provider Demographics
NPI:1821328147
Name:STETTNER, TRACY ANNE (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANNE
Last Name:STETTNER
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 1:356 BARBARA WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:CA
Mailing Address - Zip Code:94010-6760
Mailing Address - Country:US
Mailing Address - Phone:415-309-4440
Mailing Address - Fax:
Practice Address - Street 1:356 BARBARA WAY
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:CA
Practice Address - Zip Code:94010-6760
Practice Address - Country:US
Practice Address - Phone:415-309-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula