Provider Demographics
NPI:1851669782
Name:BATES, FAYE MAJA (CNM)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:MAJA
Last Name:BATES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:290 N WAYTE LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2124
Practice Address - Country:US
Practice Address - Phone:559-459-5755
Practice Address - Fax:559-459-4453
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1976163WM0102X, 163WX0002X, 163WX0003X, 176B00000X
CA1976367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No176B00000XOther Service ProvidersMidwife