Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-164727 | CA |
NPI | 1154922722 |
---|---|
Provider Name | Ashley Elizabeth Tehrani |
First Address | San Diego, CA 92104-3481 |
Second Address | San Diego, CA 92104-3481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2020 |
Last Update Date | 02/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-164727 | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (01) |