Provider Demographics
NPI:1477991511
Name:ARANDA MEDCROFT, MEDIA LEONES (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:MEDIA
Middle Name:LEONES
Last Name:ARANDA MEDCROFT
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 1:17 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BOLINAS
Mailing Address - State:CA
Mailing Address - Zip Code:94924-8717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BOLINAS
Practice Address - State:CA
Practice Address - Zip Code:94924-8717
Practice Address - Country:US
Practice Address - Phone:510-710-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA761087163W00000X, 163WC1500X, 163WH1000X, 163WM0102X, 163WW0101X
CA11295307163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory