Provider Demographics
NPI:1558640409
Name:KATZAP-NACKMAN, YANA (BA, IBCLC, RLC)
Entity Type:Individual
Prefix:MRS
First Name:YANA
Middle Name:
Last Name:KATZAP-NACKMAN
Suffix:
Gender:F
Credentials:BA, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13428 MAXELLA AVE
Mailing Address - Street 2:# 526
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292
Mailing Address - Country:US
Mailing Address - Phone:323-240-6002
Mailing Address - Fax:
Practice Address - Street 1:13428 MAXELLA AVE
Practice Address - Street 2:# 526
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292
Practice Address - Country:US
Practice Address - Phone:323-240-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10931433174N00000X
CA1183001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174N00000XOther Service ProvidersLactation Consultant, Non-RN