Provider Demographics
NPI:1891106035
Name:CALIFORNIA MIDWIVES FOR WOMEN
Entity type:Organization
Organization Name:CALIFORNIA MIDWIVES FOR WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANEVOLD
Authorized Official - Suffix:
Authorized Official - Credentials:NMW
Authorized Official - Phone:916-543-2824
Mailing Address - Street 1:605 LINCOLN BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-1870
Mailing Address - Country:US
Mailing Address - Phone:916-543-2824
Mailing Address - Fax:916-543-2842
Practice Address - Street 1:605 LINCOLN BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-1870
Practice Address - Country:US
Practice Address - Phone:916-543-2824
Practice Address - Fax:916-543-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 774520163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty