Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-34739 | CA |
NPI | 1063047983 |
---|---|
Provider Name | Ms. Tamesha Patrice Valverde |
First Address | Stockton, CA 95207-4835 |
Second Address | Stockton, CA 95207-6225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2020 |
Last Update Date | 11/03/2020 |