Provider Demographics
NPI:1982014023
Name:MCCABE, MAREN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MAREN
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 ALAMEDA DE LAS PULGAS # 418
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3507
Mailing Address - Country:US
Mailing Address - Phone:415-792-9508
Mailing Address - Fax:
Practice Address - Street 1:1025 ALAMEDA DE LAS PULGAS # 418
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3507
Practice Address - Country:US
Practice Address - Phone:415-792-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA729539163W00000X
CAL-67576163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse