Healthcare Provider Details

I. General information

NPI: 1558232058
Provider Name (Legal Business Name): GLOBAL WOMEN FOUNDATION & BAND OF BROTHERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WILSHIRE BLVD STE 700
SANTA MONICA CA
90401-3602
US

IV. Provider business mailing address

100 WILSHIRE BLVD STE 700
SANTA MONICA CA
90401-3602
US

V. Phone/Fax

Practice location:
  • Phone: 747-224-1253
  • Fax:
Mailing address:
  • Phone: 747-224-1253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRANDY GRAY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 602-400-7119