Individual
JOAN S GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
36 CHARLES LN, LAGUNITAS, CA 94938
(415) 488-1406
Mailing address
PO BOX 367, LAGUNITAS, CA 94938-0367
(415) 488-1406
(415) 488-1377
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM 138
CA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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