Provider Demographics
NPI:1831451475
Name:LEIPELT, ANGELIA (IBCLC, ICCE, CLE, BA)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:
Last Name:LEIPELT
Suffix:
Gender:F
Credentials:IBCLC, ICCE, CLE, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 HAMSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-8432
Mailing Address - Country:US
Mailing Address - Phone:209-210-8464
Mailing Address - Fax:
Practice Address - Street 1:580 HAMSTEAD DR
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-8432
Practice Address - Country:US
Practice Address - Phone:209-210-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10929038174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN