Provider Demographics
NPI:1700664026
Name:FENTON, RACHEL (IBCLC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:FENTON
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 1:600 RAINBOW DR APT 177
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-2521
Mailing Address - Country:US
Mailing Address - Phone:702-204-7347
Mailing Address - Fax:
Practice Address - Street 1:600 RAINBOW DR APT 177
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-2521
Practice Address - Country:US
Practice Address - Phone:702-204-7347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN