Provider Demographics
NPI:1831845684
Name:SMITH, BRITTANY (IBCLC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:SMITH
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 1:5344 MARCONI AVE APT 250
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4370
Mailing Address - Country:US
Mailing Address - Phone:510-928-3561
Mailing Address - Fax:
Practice Address - Street 1:5344 MARCONI AVE APT 250
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4370
Practice Address - Country:US
Practice Address - Phone:510-928-3561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2025-01-23
Deactivation Date:2022-03-07
Deactivation Code:
Reactivation Date:2025-01-23
Provider Licenses
StateLicense IDTaxonomies
171400000X, 172V00000X, 174H00000X
CA374J00000X
CAL-302513174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula