Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM408 | CA |
NPI | 1043455926 |
---|---|
Provider Name | Ms. Jasmine Michelle Maes |
First Address | Santa Rosa, CA 95403-1415 |
Second Address | Santa Rosa, CA 95403-1415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2008 |
Last Update Date | 06/10/2015 |