Provider Demographics
NPI:1528896578
Name:BRILLIANT BIRTHS
Entity type:Organization
Organization Name:BRILLIANT BIRTHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KATE
Authorized Official - Suffix:
Authorized Official - Credentials:CHILDBIRTH EDUCATOR
Authorized Official - Phone:510-384-5575
Mailing Address - Street 1:1411 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-2001
Mailing Address - Country:US
Mailing Address - Phone:510-384-5575
Mailing Address - Fax:
Practice Address - Street 1:1809 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-1950
Practice Address - Country:US
Practice Address - Phone:510-214-6251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing