Provider Demographics
NPI:1033917760
Name:KWOCK, MICHELLE (IBCLC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KWOCK
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 1:235 WESTLAKE CTR # 107
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1430
Mailing Address - Country:US
Mailing Address - Phone:415-577-5909
Mailing Address - Fax:
Practice Address - Street 1:2409 SACRAMENTO ST # 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2225
Practice Address - Country:US
Practice Address - Phone:628-285-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-317517174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN