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General NPI Number Information
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NPI Number | 1003617945
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Entity Type | Organization
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Legal Business Name | DIVINE BIRTHWORK OF HEART LLC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 602 HUMMINGBIRD WAY
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City | SUISUN CITY
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State | CA
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Zip | 94585-2208
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Country | US
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Telephone | 707-386-0414
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 SUISUN VALLEY RD SUITE E 1009
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City | FAIRFIELD
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State | CA
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Zip | 94534
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KURITA POWELL
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Credential |
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Telephone | 707-386-0414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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