Provider Demographics
NPI:1356023154
Name:DIVINE MAMA DOULA LLC
Entity type:Organization
Organization Name:DIVINE MAMA DOULA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING FULL-SPECTRUM DOULA/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VOCHERI
Authorized Official - Middle Name:MARLO
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-529-5037
Mailing Address - Street 1:5553 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-3108
Mailing Address - Country:US
Mailing Address - Phone:916-529-5037
Mailing Address - Fax:
Practice Address - Street 1:5553 37TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-3108
Practice Address - Country:US
Practice Address - Phone:916-529-5037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty