Organization Active NPI

Tourmaline Birth and Wellness Collective

  • Midwife
  • San Diego, CA
National Provider Identifier
1043859168
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Legal business name
TOURMALINE BIRTH AND WELLNESS COLLECTIVE
Practice address
4545 Fanuel St
San Diego, CA 92109-2904
Phone
(714) 585-6197
NPI assigned
Jan 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Maral Shabak, LM, CPM
Title
Owner
Phone
(714) 585-6197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 176B00000X Primary

Addresses

Primary practice location

4545 Fanuel St
San Diego, CA 92109-2904

Mailing address

4545 Fanuel St
San Diego, CA 92109-2904
Phone (714) 585-6197

National Provider Directory

National Provider Directory

Locations

4545 Fanuel St
San Diego, CA 92109
Phone (858) 200-6462

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1043859168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 FANUEL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092904",
            "telephone_number": "714-585-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 FANUEL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092904",
            "telephone_number": "714-585-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOURMALINE BIRTH AND WELLNESS COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "SHABAK",
        "authorized_official_first_name": "MARAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-585-6197",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LM, CPM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.