Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-33935 | CA |
NPI | 1003197864 |
---|---|
Provider Name | Jennifer Liza Suffin |
First Address | Burlingame, CA 94010-5109 |
Second Address | San Francisco, CA 94114-1609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2011 |
Last Update Date | 19/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-33935 | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (01) |