Provider Demographics
NPI:1326836818
Name:MIRONENKO, TATIANA (DOULA)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:MIRONENKO
Suffix:
Gender:
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11940 RHODA CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-1006
Mailing Address - Country:US
Mailing Address - Phone:808-634-8018
Mailing Address - Fax:
Practice Address - Street 1:11940 RHODA CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-1006
Practice Address - Country:US
Practice Address - Phone:808-634-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty