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NPI Code Detail

MEDICARE: MRS. CHRISIE ROSENTHAL IBCLC

MEDICARE:  MRS. CHRISIE  ROSENTHAL  IBCLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174N00000XLactation Consultant (Non-RN)11190579CA

General Provider Information

NPI Number : 1013293455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISIE ROSENTHAL IBCLC
Provider Business Mailing Address
First Line : 22901 VALERIO ST
Second Line :
City : WEST HILLS
State : CA
Zip : 91307-2129
Country : US
Telephone Number : 818-216-2319
Fax Number :
Provider Business Practice Location Address
First Line : 22901 VALERIO ST
Second Line :
City : WEST HILLS
State : CA
Zip : 91307-2129
Country : US
Telephone Number : 818-216-2319
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 03/24/2026

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