NPIMap

Organization Active NPI

Sacred Entrance Midwifery Services

  • Midwife
  • Los Angeles, CA
National Provider Identifier
1093916694
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
201 Issued in CA
Legal business name
SACRED ENTRANCE MIDWIFERY SERVICES
Practice address
11965 Venice Blvd
Suite# 204
Los Angeles, CA 90066-3979
Phone
(310) 566-7690
Fax
(310) 566-7699
NPI assigned
May 30, 2007
Last updated
Dec 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Aleksandra Evangueulidi, L.M., CPM
Title
Owner
Phone
(310) 566-7690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 201 CA Primary

Addresses

Primary practice location

11965 Venice Blvd
Suite# 204
Los Angeles, CA 90066-3979

Mailing address

11965 Venice Blvd
Suite# 204
Los Angeles, CA 90066-3979
Phone (310) 566-7690

National Provider Directory

National Provider Directory

Locations

11965 Venice Blvd
Ste 204
Los Angeles, CA 90066
Phone (310) 566-7690

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1093916694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11965 VENICE BLVD",
            "address_2": "SUITE# 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663979",
            "telephone_number": "310-566-7690",
            "fax_number": "310-566-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11965 VENICE BLVD",
            "address_2": "SUITE# 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663979",
            "telephone_number": "310-566-7690",
            "fax_number": "310-566-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED ENTRANCE MIDWIFERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "EVANGUEULIDI",
        "authorized_official_first_name": "ALEKSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-566-7690",
        "authorized_official_credential": "L.M., CPM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.