Provider Demographics
NPI:1952160111
Name:BRAY, SARAH JEAN (DOULA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:BRAY
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:EDMONDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula