Provider Demographics
NPI:1518590124
Name:FELDMAN, MICHAL SHAVIT (IBCLC)
Entity type:Individual
Prefix:
First Name:MICHAL
Middle Name:SHAVIT
Last Name:FELDMAN
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 1:607 BOSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-3246
Mailing Address - Country:US
Mailing Address - Phone:617-834-4969
Mailing Address - Fax:
Practice Address - Street 1:607 BOSWORTH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-3246
Practice Address - Country:US
Practice Address - Phone:617-834-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-164743174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN