Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 539 | CA |
NPI | 1134890080 |
---|---|
Provider Name | Sandra Ivonne Iraheta |
First Address | Santa Barbara, CA 93103-3071 |
Second Address | Santa Barbara, CA 93101-2501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2021 |
Last Update Date | 21/09/2021 |