Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-35064 | CA |
NPI | 1164898623 |
---|---|
Provider Name | Christine Staricka |
First Address | Bakersfield, CA 93308-1944 |
Second Address | Bakersfield, CA 93308-1944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2015 |
Last Update Date | 18/08/2015 |