Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 87687 | CA |
NPI | 1174998546 |
---|---|
Provider Name | Christine Silva |
First Address | Arroyo Grande, CA 93420-4977 |
Second Address | Arroyo Grande, CA 93420-4977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2015 |
Last Update Date | 10/12/2015 |