Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | #207 | CA |
NPI | 1093854689 |
---|---|
Provider Name | Judith Eve-Marie Luce |
First Address | Berkeley, CA 94703-2317 |
Second Address | Berkeley, CA 94703-2317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 08/07/2007 |