Provider Demographics
NPI:1740960855
Name:HEBBARD-CONTRERAS, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HEBBARD-CONTRERAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12558 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-4711
Mailing Address - Country:US
Mailing Address - Phone:909-725-6207
Mailing Address - Fax:
Practice Address - Street 1:12558 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-4711
Practice Address - Country:US
Practice Address - Phone:909-725-6207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95137305163WC1500X, 163WM0102X, 163WP1700X, 163WP2201X, 163WL0100X
174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No174N00000XOther Service ProvidersLactation Consultant, Non-RN