Mariah Marianne Van Dyke, LM, CPM

Primary specialty

MidwifeTaxonomy code 176B00000X

License

LM691 Issued in CA

Practice address

1727 South St
Redding, CA 96001-1812

Phone

(530) 722-7569

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1467179226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 VICTOR AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020407",
            "telephone_number": "530-722-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SOUTH ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011812",
            "telephone_number": "530-722-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "MARIAH",
        "middle_name": "MARIANNE",
        "name_prefix": "Mrs.",
        "credential": "LM, CPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NARM",
            "identifier": "CPM22080027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA",
            "identifier": "LM691",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeff Van Ausdall
• Rosemarie B Van Der Jagt, M.A. CCC-SLP
• Mone Van Der Linde
• John Van Der Werff, DDS
• Byron James Van Dyke, M.D.
• Cheree Nichole Van Eyck
• Jon Alan Van Fossan
• Andrew G Van Horn-Gibson
• Samuel D Van Kirk, MD
• Andre' Van Mol, MD

• Midwife in Redding, CA
• Providers in Redding, CA by specialty
• Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.