Provider Demographics
NPI:1477362606
Name:THE MOTHER'S ROOM LLC
Entity type:Organization
Organization Name:THE MOTHER'S ROOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ERIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:916-212-1345
Mailing Address - Street 1:4738 GARDENIA ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6142
Mailing Address - Country:US
Mailing Address - Phone:916-212-1345
Mailing Address - Fax:
Practice Address - Street 1:4738 GARDENIA ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-6142
Practice Address - Country:US
Practice Address - Phone:916-212-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty