Provider Demographics
NPI:1942828140
Name:BARRETT, MEGAN ZOE (IBCLC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ZOE
Last Name:BARRETT
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 1:49 BONITA AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3947
Mailing Address - Country:US
Mailing Address - Phone:626-272-6018
Mailing Address - Fax:
Practice Address - Street 1:49 BONITA AVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:CA
Practice Address - Zip Code:94611-3947
Practice Address - Country:US
Practice Address - Phone:626-272-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-165314174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN