Provider Demographics
NPI:1700690724
Name:ORTIZ, PALOMA NATALY (IBCLC)
Entity type:Individual
Prefix:
First Name:PALOMA
Middle Name:NATALY
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:NATALY
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IBCLC
Mailing Address - Street 1:320 MARIGOLD AVE
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:CA
Mailing Address - Zip Code:95019-3118
Mailing Address - Country:US
Mailing Address - Phone:831-515-9686
Mailing Address - Fax:
Practice Address - Street 1:320 MARIGOLD AVE
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:CA
Practice Address - Zip Code:95019-3118
Practice Address - Country:US
Practice Address - Phone:831-515-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-317184174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN