Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM121 | CA |
NPI | 1073633632 |
---|---|
Provider Name | Tanya Khemet Taiwo |
First Address | Sacramento, CA 95822-4128 |
Second Address | Davis, CA 95616-9701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 24/12/2019 |