Provider Demographics
NPI:1952917189
Name:BENADO, KAYLA (IBCLC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BENADO
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 1:4653 CALIFORNIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-4158
Mailing Address - Country:US
Mailing Address - Phone:805-890-7989
Mailing Address - Fax:
Practice Address - Street 1:4653 CALIFORNIA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-4158
Practice Address - Country:US
Practice Address - Phone:805-890-7989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL152107174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN