Provider Demographics
NPI:1710708474
Name:LA MATRIZ BIRTH SERVICES INC
Entity type:Organization
Organization Name:LA MATRIZ BIRTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:V
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:408-209-2234
Mailing Address - Street 1:6752 HIBISCUS DR
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-1316
Mailing Address - Country:US
Mailing Address - Phone:408-209-2223
Mailing Address - Fax:619-761-5825
Practice Address - Street 1:3633 CAMINO DEL RIO SOUTH
Practice Address - Street 2:STE 206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:408-209-2234
Practice Address - Fax:619-761-5825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty