Provider Demographics
NPI:1942535844
Name:FARVER, MARIE-CELINE (RN BSN IBCLC RLC)
Entity Type:Individual
Prefix:MRS
First Name:MARIE-CELINE
Middle Name:
Last Name:FARVER
Suffix:
Gender:F
Credentials:RN BSN IBCLC RLC
Other - Prefix:MRS
Other - First Name:MARIE-CELINE
Other - Middle Name:
Other - Last Name:FARVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN BSN IBCLC RLC
Mailing Address - Street 1:635 HUBBLE ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2722
Mailing Address - Country:US
Mailing Address - Phone:530-753-8319
Mailing Address - Fax:530-750-1444
Practice Address - Street 1:635 HUBBLE STREET
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2722
Practice Address - Country:US
Practice Address - Phone:530-753-8319
Practice Address - Fax:530-750-1444
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106-22909163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant