Provider Demographics
NPI:1134541824
Name:ROSEN, JODI LYNN (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:ROSEN
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 1:44226 10TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4134
Mailing Address - Country:US
Mailing Address - Phone:661-433-3587
Mailing Address - Fax:
Practice Address - Street 1:44226 10TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4134
Practice Address - Country:US
Practice Address - Phone:661-433-3587
Practice Address - Fax:661-951-9715
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438120163WL0100X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant