Individual
MISS BROOKE AMBER LA SAULLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P. & CNM
Contact information
Practice address
1950 GREENFIELD AVE, LOS ANGELES, CA 90025-5712
(415) 218-3981
Mailing address
1950 GREENFIELD AVE, LOS ANGELES, CA 90025-5712
(415) 218-3981
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
NMW1783
CA
363L00000X
Nurse Practitioner
17578
CA
367A00000X
Advanced Practice Midwife
Primary
NMW1783
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NMW1783
MEDICAL LICENSE
CA
Enumeration date
10/16/2007
Last updated
09/21/2022
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