Provider Demographics
NPI:1124395611
Name:WINFREY, CELEST I (LM, CPM, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:CELEST
Middle Name:I
Last Name:WINFREY
Suffix:
Gender:F
Credentials:LM, CPM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 LA SIERRA WAY
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1509
Mailing Address - Country:US
Mailing Address - Phone:310-494-6097
Mailing Address - Fax:323-680-4967
Practice Address - Street 1:2141 LA SIERRA WAY
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1509
Practice Address - Country:US
Practice Address - Phone:310-494-6097
Practice Address - Fax:323-680-4967
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM558176B00000X
CAL-34952174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174N00000XOther Service ProvidersLactation Consultant, Non-RN