Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11019787 | CA |
NPI | 1013252840 |
---|---|
Provider Name | Lisa Piediscalzi |
First Address | Santa Cruz, CA 95062-1233 |
Second Address | Santa Cruz, CA 95062-1233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2012 |
Last Update Date | 14/11/2013 |