Provider Demographics
NPI:1407290257
Name:HOWSER, KATIE (IBCLC, CPD(DONA))
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:HOWSER
Suffix:
Gender:F
Credentials:IBCLC, CPD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 SHOEMAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-9528
Mailing Address - Country:US
Mailing Address - Phone:209-968-5197
Mailing Address - Fax:
Practice Address - Street 1:5130 MANILA AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1020
Practice Address - Country:US
Practice Address - Phone:209-968-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
CA45579174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula