Provider Demographics
NPI:1790467181
Name:LACTATION CONSULTANTS OF AMERICA
Entity Type:Organization
Organization Name:LACTATION CONSULTANTS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-223-4208
Mailing Address - Street 1:6236 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3144
Mailing Address - Country:US
Mailing Address - Phone:650-223-4208
Mailing Address - Fax:833-563-2266
Practice Address - Street 1:13579 SW FEIRING LN
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-1605
Practice Address - Country:US
Practice Address - Phone:971-217-3660
Practice Address - Fax:833-563-2266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LACTATION CONSULTANTS OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty