Provider Demographics
NPI:1720874605
Name:OBRIEN, ATHENA (DOULA)
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:OBRIEN
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 1:6805 CORYBUS ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-8215
Mailing Address - Country:US
Mailing Address - Phone:909-477-1910
Mailing Address - Fax:
Practice Address - Street 1:6805 CORYBUS ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-8215
Practice Address - Country:US
Practice Address - Phone:909-477-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula