Provider Demographics
NPI:1386040285
Name:WHITE, JAHMILA (IBCLC)
Entity Type:Individual
Prefix:
First Name:JAHMILA
Middle Name:
Last Name:WHITE
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 1:20440 VIA PAVISO APT G32
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-7001
Mailing Address - Country:US
Mailing Address - Phone:408-726-9615
Mailing Address - Fax:
Practice Address - Street 1:20440 VIA PAVISO APT G32
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-7001
Practice Address - Country:US
Practice Address - Phone:408-726-9615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN