Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-13221 | CA |
NPI | 1114683448 |
---|---|
Provider Name | Jacqueline Aguas |
First Address | Merced, CA 95340-4524 |
Second Address | Merced, CA 95340-4524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2021 |
Last Update Date | 10/11/2021 |