Supinda Sirihekaphong

Primary specialty

DoulaTaxonomy code 374J00000X

License

13013 Issued in IL

Practice address

6259 Adobe Rd # a-1
Twentynine Palms, CA 92277-2649

Phone

(760) 206-6467

NPI assigned

Aug 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1295454502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 ADOBE RD # A-1",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772649",
            "telephone_number": "760-206-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6259 ADOBE RD # A-1",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772649",
            "telephone_number": "760-206-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIHEKAPHONG",
        "first_name": "SUPINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "95831",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "IL",
            "license": "13013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Sena-Bolding, PT
• Kirra Irene Senne, MMS, PA-C
• Maria T Sheldrake, O.D.
• Alonzo Jamelle Shields, IDC
• Christopher Masaki Shimizu, DDS
• Courtney Nicole Smith, IDC
• Rachel Smith, RD
• William Smith III, DC
• Ryan Snow, MD
• Skylar Jo Snowden, DMD

• Doula in Twentynine Palms, CA
• Providers in Twentynine Palms, CA by specialty
• Doula in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.