Justine E Waldram, L.M.

Primary specialty

MidwifeTaxonomy code 176B00000X

License

LM 406 Issued in CA

Practice address

4251 S Higuera St Ste 300
San Luis Obispo, CA 93401-7741

Phone

(805) 994-0074

NPI assigned

Dec 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Justine E McManis Former name

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": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1356749832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 S HIGUERA ST STE 300",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017741",
            "telephone_number": "805-994-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 S HIGUERA ST STE 300",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017741",
            "telephone_number": "805-994-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRAM",
        "first_name": "JUSTINE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "L.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM 406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "MCMANIS",
            "middle_name": "E",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachael Mae Wahl, LVN
• Taylor Suzanne Wahl, PA-C
• Rose Charlotte Wakeland
• Anna Katrina Walden
• Nancy J Walden, FNP
• James Kirk Waldsmith, DVM
• Caroline Arlene Wales, PHD-I, CHLC
• Christopher Walheim, MD
• Lydia Ann P Walker, RN
• Robin Rae Walker, LPCC14314

• Midwife in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.