Provider Demographics
NPI:1407001969
Name:EDGAR, MICHELLE DAWN (LM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DAWN
Last Name:EDGAR
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 CAMINO DIABLO STE 140
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3801
Mailing Address - Country:US
Mailing Address - Phone:510-655-2229
Mailing Address - Fax:510-845-1700
Practice Address - Street 1:3101 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1984
Practice Address - Country:US
Practice Address - Phone:510-280-5543
Practice Address - Fax:510-255-2058
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
CALM237176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula