Provider Demographics
NPI:1043074651
Name:DOULA VINE
Entity type:Organization
Organization Name:DOULA VINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-308-5508
Mailing Address - Street 1:23986 ALISO CREEK RD # 319
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3908
Mailing Address - Country:US
Mailing Address - Phone:816-308-5508
Mailing Address - Fax:
Practice Address - Street 1:2015 VIA CONCHA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-5613
Practice Address - Country:US
Practice Address - Phone:816-308-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty