Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-14360 | CA |
NPI | 1093387219 |
---|---|
Provider Name | Adrienne Guirguis |
First Address | Bakersfield, CA 93312-2971 |
Second Address | Bakersfield, CA 93312-2971 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2021 |
Last Update Date | 15/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-14360 | IBLCE (01) | CA |