Provider Demographics
NPI:1841980778
Name:GUTOWSKY, BRANDEE (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:BRANDEE
Middle Name:
Last Name:GUTOWSKY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 SEENO AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6044
Mailing Address - Country:US
Mailing Address - Phone:562-665-0185
Mailing Address - Fax:
Practice Address - Street 1:8202 SEENO AVE
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-6044
Practice Address - Country:US
Practice Address - Phone:562-665-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA843599163WL0100X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse