Provider Demographics
NPI:1740045897
Name:EDELSHTAIN, YULIA MEDOVOY
Entity type:Individual
Prefix:
First Name:YULIA
Middle Name:MEDOVOY
Last Name:EDELSHTAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YULIA
Other - Middle Name:MEDOVOY
Other - Last Name:EDELSHTAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOULA
Mailing Address - Street 1:6149 ALCOTT ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3701
Mailing Address - Country:US
Mailing Address - Phone:323-377-0707
Mailing Address - Fax:323-653-5669
Practice Address - Street 1:6149 ALCOTT ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-3701
Practice Address - Country:US
Practice Address - Phone:323-377-0707
Practice Address - Fax:323-653-5669
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0002426481-0001-2374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula