Provider Demographics
NPI:1760212948
Name:PUSHPUSHBABY, LLC
Entity type:Organization
Organization Name:PUSHPUSHBABY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIRTH & POSTPARTUM TRAINED DOULA
Authorized Official - Prefix:
Authorized Official - First Name:LATISHA
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:TRAINED DOULA
Authorized Official - Phone:916-281-5616
Mailing Address - Street 1:PO BOX 10998
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-0998
Mailing Address - Country:US
Mailing Address - Phone:916-281-5616
Mailing Address - Fax:
Practice Address - Street 1:1650 WAKEFIELD WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4627
Practice Address - Country:US
Practice Address - Phone:916-281-5616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty