Provider Demographics
NPI:1407417058
Name:SAVILLE, ELIZABETH (IBCLC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SAVILLE
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 1:1508 W BONNIE BRAE CT
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-1012
Mailing Address - Country:US
Mailing Address - Phone:909-542-3363
Mailing Address - Fax:909-542-3361
Practice Address - Street 1:1508 W BONNIE BRAE CT
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-1012
Practice Address - Country:US
Practice Address - Phone:909-542-3363
Practice Address - Fax:909-542-3361
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-156574174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty