Provider Demographics
NPI:1487079992
Name:DONENFELD, JAMIE LOUISE (CNM)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LOUISE
Last Name:DONENFELD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10557 ROCCA PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2904
Mailing Address - Country:US
Mailing Address - Phone:310-471-3777
Mailing Address - Fax:
Practice Address - Street 1:10557 ROCCA PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-2904
Practice Address - Country:US
Practice Address - Phone:310-567-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANM1217367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife