Provider Demographics
NPI:1255085643
Name:BREWER, TALITHA JANNELLE (DOULA)
Entity type:Individual
Prefix:
First Name:TALITHA
Middle Name:JANNELLE
Last Name:BREWER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:TALITHA
Other - Middle Name:JANNELLE
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOULA
Mailing Address - Street 1:1456 ALTURAS RD APT 17
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3942
Mailing Address - Country:US
Mailing Address - Phone:858-987-3298
Mailing Address - Fax:
Practice Address - Street 1:1456 ALTURAS RD APT 17
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3942
Practice Address - Country:US
Practice Address - Phone:858-987-3298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN