Provider Demographics
NPI:1871258038
Name:MANZANITA MIDWIFERY
Entity Type:Organization
Organization Name:MANZANITA MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:OQUENDO
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, PHD
Authorized Official - Phone:805-458-2611
Mailing Address - Street 1:191 CARRISA HWY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:93453-9755
Mailing Address - Country:US
Mailing Address - Phone:805-458-2611
Mailing Address - Fax:805-856-0391
Practice Address - Street 1:191 CARRISA HWY
Practice Address - Street 2:
Practice Address - City:SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:93453-9755
Practice Address - Country:US
Practice Address - Phone:805-458-2611
Practice Address - Fax:805-856-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty