Provider Demographics
NPI:1801500186
Name:GIVEN, MADELINE (NC, BCHN, IBCLC)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:GIVEN
Suffix:
Gender:F
Credentials:NC, BCHN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 CARLO DR
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1749
Mailing Address - Country:US
Mailing Address - Phone:805-680-2117
Mailing Address - Fax:
Practice Address - Street 1:515 CARLO DR
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-1749
Practice Address - Country:US
Practice Address - Phone:805-680-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN