Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-142982 | CA |
NPI | 1225513112 |
---|---|
Provider Name | Ms. Yasmin Dera Baskin |
First Address | Carson, CA 90745-2260 |
Second Address | Los Angeles, CA 90004-2434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2018 |
Last Update Date | 26/09/2018 |