Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11120134 |
NPI | 1083988810 |
---|---|
Provider Name | Jessica Claire |
First Address | Los Angeles, CA 90041-2221 |
Second Address | Los Angeles, CA 90041-2221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2012 |
Last Update Date | 25/05/2016 |