Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11176950 | CA |
NPI | 1366787913 |
---|---|
Provider Name | Sandra Mercedes Lemus-Gonzalez |
First Address | Torrance, CA 90510-3325 |
Second Address | Torrance, CA 90501-5106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2012 |
Last Update Date | 09/12/2012 |