Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11167962 | CA |
NPI | 1104175769 |
---|---|
Provider Name | Ms. Tamentanefer Lumukanda |
First Address | Oakland, CA 94601 |
Second Address | Oakland, CA 94601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2012 |
Last Update Date | 29/08/2012 |