Individual
TATIANA KOONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
3830 VALLEY CENTRE DR # 705-246, SAN DIEGO, CA 92130
(858) 221-6040
Mailing address
3830 VALLEY CENTRE DR # 705-246, SAN DIEGO, CA 92130-3320
(858) 221-6040
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
559
CA
374J00000X
Doula
—
—
Other
Enumeration date
09/02/2014
Last updated
03/28/2019
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