Provider Demographics
NPI:1275826299
Name:WATKINS, SHARON CASTANEDA (LVN,CLE,IBCLC,RLC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:CASTANEDA
Last Name:WATKINS
Suffix:
Gender:F
Credentials:LVN,CLE,IBCLC,RLC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:CASTANEDA
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IBCLC,RLC
Mailing Address - Street 1:155 GARDENSIDE DR
Mailing Address - Street 2:#28
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-3313
Mailing Address - Country:US
Mailing Address - Phone:415-550-1877
Mailing Address - Fax:415-550-2688
Practice Address - Street 1:155 GARDENSIDE DR
Practice Address - Street 2:#28
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-3313
Practice Address - Country:US
Practice Address - Phone:415-550-1877
Practice Address - Fax:415-550-2688
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10948640174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN