Provider Demographics
NPI:1437420676
Name:RANDLETT MAJOR, SHARON ANNAMARIE (RN, BS, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANNAMARIE
Last Name:RANDLETT MAJOR
Suffix:
Gender:F
Credentials:RN, BS, IBCLC
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Other - First Name:
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Mailing Address - Street 1:34011 AURELIO DR
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2605
Mailing Address - Country:US
Mailing Address - Phone:949-422-1577
Mailing Address - Fax:949-481-8757
Practice Address - Street 1:777 CORPORATE DR
Practice Address - Street 2:STE 250
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-2135
Practice Address - Country:US
Practice Address - Phone:949-422-1577
Practice Address - Fax:949-481-8757
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA314533163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45-4205059OtherIRS EIN