Provider Demographics
NPI:1336993666
Name:AZAROVITZ, TAMI L (IBCLC)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:L
Last Name:AZAROVITZ
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 1:6849 SPRINGVIEW PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-4893
Mailing Address - Country:US
Mailing Address - Phone:909-331-1448
Mailing Address - Fax:
Practice Address - Street 1:6849 SPRINGVIEW PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-4893
Practice Address - Country:US
Practice Address - Phone:909-331-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-19284174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN