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Organization

THE DIVINE BIRTH ACADEMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KHADIJA FOX CHD, CLES (CEO)
(209) 922-4489
Entity
Organization

Contact information

Practice address
1933 W ROSE ST, STOCKTON, CA 95203-1326
(209) 922-4489
Mailing address
1933 W ROSE ST, STOCKTON, CA 95203-1326
(209) 922-4489

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
163WP1700X
Perinatal Registered Nurse
172V00000X
Community Health Worker
174N00000X
Lactation Consultant (Non-RN)
374J00000X
Doula
Primary

Other

Enumeration date
06/06/2024
Last updated
06/06/2024
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