Provider Demographics
NPI:1831443191
Name:ENGELBRECHT, KARA JO (LM CPM)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:JO
Last Name:ENGELBRECHT
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3417
Mailing Address - Country:US
Mailing Address - Phone:415-793-6728
Mailing Address - Fax:415-226-0669
Practice Address - Street 1:2543 BRYANT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3417
Practice Address - Country:US
Practice Address - Phone:415-793-6728
Practice Address - Fax:415-226-0669
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 348176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife