Provider Demographics
NPI:1164257887
Name:A GRACEFUL JOURNEY DOULA SERVICES
Entity type:Organization
Organization Name:A GRACEFUL JOURNEY DOULA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:EDMONDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-319-6943
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-0174
Mailing Address - Country:US
Mailing Address - Phone:707-319-6943
Mailing Address - Fax:
Practice Address - Street 1:305 W M ST
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2707
Practice Address - Country:US
Practice Address - Phone:707-319-6943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty