Provider Demographics
NPI:1447831219
Name:INTIMATE JOURNEY BIRTH & WELLNESS
Entity type:Organization
Organization Name:INTIMATE JOURNEY BIRTH & WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:ELISSA
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:805-270-4466
Mailing Address - Street 1:3940 BROAD ST STE 7
Mailing Address - Street 2:#204
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:970-799-2512
Mailing Address - Fax:
Practice Address - Street 1:4251 S HIGUERA ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7741
Practice Address - Country:US
Practice Address - Phone:805-270-4466
Practice Address - Fax:805-855-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty