Provider Demographics
NPI:1689483075
Name:STURTEVANT, AIDA HERLINDA
Entity type:Individual
Prefix:MS
First Name:AIDA
Middle Name:HERLINDA
Last Name:STURTEVANT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AIDA
Other - Middle Name:HERLINDA
Other - Last Name:STURTEVANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12811 CALLE DE LAS ROSAS
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3014
Mailing Address - Country:US
Mailing Address - Phone:619-302-1661
Mailing Address - Fax:
Practice Address - Street 1:12811 CALLE DE LAS ROSAS
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-3014
Practice Address - Country:US
Practice Address - Phone:619-302-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB2009004750374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula