Provider Demographics
NPI:1861282477
Name:DIVINE ANCESTORS BIRTHWORKS LLC
Entity type:Organization
Organization Name:DIVINE ANCESTORS BIRTHWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEGIBOW
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:963-669-6270
Mailing Address - Street 1:2036 RENZ RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CA
Mailing Address - Zip Code:95938-9627
Mailing Address - Country:US
Mailing Address - Phone:925-392-5878
Mailing Address - Fax:
Practice Address - Street 1:2036 RENZ RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CA
Practice Address - Zip Code:95938-9627
Practice Address - Country:US
Practice Address - Phone:925-392-5878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty