Provider Demographics
NPI:1912744137
Name:PEACEFUL PASSAGES BIRTHING SUPPORT CENTER
Entity type:Organization
Organization Name:PEACEFUL PASSAGES BIRTHING SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOMEZ KNUPP
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RNC-OB, CD, CCE
Authorized Official - Phone:954-899-7391
Mailing Address - Street 1:2575 E PERRIN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-5204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2575 E PERRIN AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-5204
Practice Address - Country:US
Practice Address - Phone:949-688-3967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatalGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-RiskGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No175M00000XOther Service ProvidersMidwife, LayGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty