Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-107370 | CA |
NPI | 1205313707 |
---|---|
Provider Name | Carolina Jones |
First Address | Sacramento, CA 95823-5347 |
Second Address | Sacramento, CA 95823-5347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2018 |
Last Update Date | 26/07/2018 |