Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-306130 | CA |
NPI | 1194478461 |
---|---|
Provider Name | Victoria Alice Talbot-Whittaker |
First Address | Tustin, CA 92780-4646 |
Second Address | Tustin, CA 92780-4646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2022 |
Last Update Date | 27/01/2022 |