Provider Demographics
NPI:1245051218
Name:FRUIT OF THE WOMB
Entity type:Organization
Organization Name:FRUIT OF THE WOMB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:MS
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-393-4335
Mailing Address - Street 1:2600 3RD ST APT 2055
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1163
Mailing Address - Country:US
Mailing Address - Phone:510-393-4335
Mailing Address - Fax:
Practice Address - Street 1:2600 3RD ST APT 2055
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1163
Practice Address - Country:US
Practice Address - Phone:510-393-4335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty