Provider Demographics
NPI:1386850147
Name:JANOWITZ, MARY REBECCA (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:REBECCA
Last Name:JANOWITZ
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 1:154 SHOREVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2229
Mailing Address - Country:US
Mailing Address - Phone:415-298-6707
Mailing Address - Fax:
Practice Address - Street 1:3555 CESAR CHAVEZ
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4403
Practice Address - Country:US
Practice Address - Phone:415-641-6869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10016523163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant