Healthcare Provider Details

I. General information

NPI: 1265367171
Provider Name (Legal Business Name): PACO LEADERSHIP COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1723 FRANKLIN ST
SANTA MONICA CA
90404-4207
US

IV. Provider business mailing address

1723 FRANKLIN ST
SANTA MONICA CA
90404-4207
US

V. Phone/Fax

Practice location:
  • Phone: 864-992-6365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: KARI CROFT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 864-992-6365