Provider Demographics
NPI:1790466399
Name:VERDI, SHALAND JEAN (LACTATION CONSULTANT)
Entity Type:Individual
Prefix:
First Name:SHALAND
Middle Name:JEAN
Last Name:VERDI
Suffix:
Gender:F
Credentials:LACTATION CONSULTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22254 MAYALL ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2718
Mailing Address - Country:US
Mailing Address - Phone:818-277-9444
Mailing Address - Fax:
Practice Address - Street 1:22254 MAYALL ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2718
Practice Address - Country:US
Practice Address - Phone:818-277-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-136202174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN