Provider Demographics
NPI:1023362514
Name:LIN, SARAH P (IBCLC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:P
Last Name:LIN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:P
Other - Last Name:GRODEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC
Mailing Address - Street 1:11382 VOLANS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-1345
Mailing Address - Country:US
Mailing Address - Phone:858-869-7001
Mailing Address - Fax:
Practice Address - Street 1:11382 VOLANS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-1345
Practice Address - Country:US
Practice Address - Phone:858-869-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN