Provider Demographics
NPI:1942443221
Name:BIRTH ROOTS INC
Entity Type:Organization
Organization Name:BIRTH ROOTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:619-265-5269
Mailing Address - Street 1:236 F ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-2818
Mailing Address - Country:US
Mailing Address - Phone:619-409-4900
Mailing Address - Fax:619-409-4994
Practice Address - Street 1:236 F ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2818
Practice Address - Country:US
Practice Address - Phone:619-409-4900
Practice Address - Fax:619-409-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM235176B00000X
261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty