Provider Demographics
NPI:1659789295
Name:LAU, YVONNE C (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:C
Last Name:LAU
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 1:2102 CHORAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631
Mailing Address - Country:US
Mailing Address - Phone:562-694-0723
Mailing Address - Fax:
Practice Address - Street 1:2102 CHORAL DRIVE
Practice Address - Street 2:
Practice Address - City:LA HABRA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:90631
Practice Address - Country:US
Practice Address - Phone:562-694-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIBCLC#10117409174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN