Provider Demographics
NPI:1699062737
Name:MADRONE MIDWIFERY
Entity type:Organization
Organization Name:MADRONE MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARIE MAGUIRE
Authorized Official - Last Name:SONN
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:707-445-0420
Mailing Address - Street 1:2051 OLD ARCATA RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:95524-9033
Mailing Address - Country:US
Mailing Address - Phone:707-826-1241
Mailing Address - Fax:
Practice Address - Street 1:2051 OLD ARCATA RD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:CA
Practice Address - Zip Code:95524-9033
Practice Address - Country:US
Practice Address - Phone:707-826-1241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA279176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty