Provider Demographics
NPI:1255178505
Name:DOULA ACCESS COLLECTIVE
Entity type:Organization
Organization Name:DOULA ACCESS COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:612-270-4340
Mailing Address - Street 1:16016 APRICOT AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91708-8874
Mailing Address - Country:US
Mailing Address - Phone:612-270-4340
Mailing Address - Fax:
Practice Address - Street 1:16016 APRICOT AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91708-8874
Practice Address - Country:US
Practice Address - Phone:612-270-4340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service