Active NPI
Deanna Michelle Mulder, LM, CPM
- Midwife
- San Leandro, CA
National Provider Identifier
1396124954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- LM439
- Practice address
- 789 Estudillo Ave
San Leandro, CA 94577-5109 - Phone
- (510) 421-6180
- NPI assigned
- May 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | LM439 | CA | Primary |
Addresses
Primary practice location
789 Estudillo Ave
San Leandro, CA 94577-5109
Mailing address
789 Estudillo Avenue
San Leandro, CA 94577
Phone (510) 421-6180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LM439 | Other | CA | MEDICAL BOARD OF CALIFORNIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LM439 | CA | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1396124954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "789 ESTUDILLO AVENUE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94577",
"telephone_number": "510-421-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "789 ESTUDILLO AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945775109",
"telephone_number": "510-421-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULDER",
"first_name": "DEANNA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "LM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-28",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "LM439",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD OF CALIFORNIA",
"identifier": "LM439",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.