Provider Demographics
NPI:1972067114
Name:CRAWFORD, DAVON (CD,PCD(DONA))
Entity Type:Individual
Prefix:
First Name:DAVON
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CD,PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 PORTER ST APT 201
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-7753
Mailing Address - Country:US
Mailing Address - Phone:404-484-4717
Mailing Address - Fax:
Practice Address - Street 1:1009 PORTER ST APT 201
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-7753
Practice Address - Country:US
Practice Address - Phone:404-484-4717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty