Provider Demographics
NPI:1114390200
Name:DOWD, KRISTINE (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:
Last Name:DOWD
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3114
Mailing Address - Country:US
Mailing Address - Phone:831-419-4600
Mailing Address - Fax:
Practice Address - Street 1:2615 34TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3114
Practice Address - Country:US
Practice Address - Phone:831-419-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA753363163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant