Provider Demographics
NPI:1801267166
Name:SAN DIEGO HAPPY BABIES
Entity type:Organization
Organization Name:SAN DIEGO HAPPY BABIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/POSTPARTUM DOULA
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-719-1307
Mailing Address - Street 1:55 FAIR DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-6520
Mailing Address - Country:US
Mailing Address - Phone:917-719-1307
Mailing Address - Fax:
Practice Address - Street 1:55 FAIR DR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-6520
Practice Address - Country:US
Practice Address - Phone:917-719-1307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty