Provider Demographics
NPI:1396570560
Name:LEGASPI, MAUREEN CHRISTINE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CHRISTINE
Last Name:LEGASPI
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 1:10960 W THREADGRASS ST
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669-6334
Mailing Address - Country:US
Mailing Address - Phone:310-989-4820
Mailing Address - Fax:
Practice Address - Street 1:10960 W THREADGRASS ST
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:ID
Practice Address - Zip Code:83669-6334
Practice Address - Country:US
Practice Address - Phone:310-989-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA767566163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant