Provider Demographics
NPI:1467200667
Name:FOGLE, LEAH (POSTPARTUM DOULA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:FOGLE
Suffix:
Gender:F
Credentials:POSTPARTUM DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4291 IRENE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-1443
Mailing Address - Country:US
Mailing Address - Phone:925-567-6547
Mailing Address - Fax:
Practice Address - Street 1:4291 IRENE DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-1443
Practice Address - Country:US
Practice Address - Phone:925-567-6547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula