Provider Demographics
NPI:1073970315
Name:WRONKIEWICZ, DARCY TERESA (IBCLC, CD(DONA))
Entity Type:Individual
Prefix:MS
First Name:DARCY
Middle Name:TERESA
Last Name:WRONKIEWICZ
Suffix:
Gender:F
Credentials:IBCLC, CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BUCHANAN AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2502
Mailing Address - Country:US
Mailing Address - Phone:805-570-1595
Mailing Address - Fax:805-688-6578
Practice Address - Street 1:75 BUCHANAN AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2502
Practice Address - Country:US
Practice Address - Phone:805-570-1595
Practice Address - Fax:805-688-6578
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-83668174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN