Provider Demographics
NPI:1083107940
Name:FORGET, JOSEE (IBCLC)
Entity Type:Individual
Prefix:
First Name:JOSEE
Middle Name:
Last Name:FORGET
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 E DEL MAR BLVD APT 141
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2711
Mailing Address - Country:US
Mailing Address - Phone:626-354-0011
Mailing Address - Fax:
Practice Address - Street 1:280 E DEL MAR BLVD APT 141
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2711
Practice Address - Country:US
Practice Address - Phone:626-354-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-109275174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN