Provider Demographics
NPI:1255929311
Name:BOYD, LYDIA O (IBCLC)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:O
Last Name:BOYD
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 1:11821 FOOTHILL BLVD APT UNIT45
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-7200
Mailing Address - Country:US
Mailing Address - Phone:562-221-0322
Mailing Address - Fax:
Practice Address - Street 1:11821 FOOTHILL BLVD APT UNIT45
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-7200
Practice Address - Country:US
Practice Address - Phone:562-221-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-302725174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN