Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 235889 | CA |
NPI | 1124551494 |
---|---|
Provider Name | Emily Chana Wolfe-Roubatis |
First Address | Oakland, CA 94610-4675 |
Second Address | Oakland, CA 94601-2313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 03/01/2022 |