Provider Demographics
NPI:1437451218
Name:ELOWEN, REBECCA SAMARA MORGAN (LM, IBCLC, CST-I)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:SAMARA MORGAN
Last Name:ELOWEN
Suffix:
Gender:F
Credentials:LM, IBCLC, CST-I
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:SAMARA MORGAN
Other - Last Name:PLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:POINT REYES STATION
Mailing Address - State:CA
Mailing Address - Zip Code:94956-0248
Mailing Address - Country:US
Mailing Address - Phone:415-250-6845
Mailing Address - Fax:
Practice Address - Street 1:7 MOUNT LASSEN DR
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1148
Practice Address - Country:US
Practice Address - Phone:707-893-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA277176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife