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NPI Code Detail

MEDICARE: SARAH GRUMAN IBCLC

MEDICARE: SARAH GRUMAN 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)L-303362
2374J00000XDoula

General Provider Information

NPI Number : 1174291116
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH GRUMAN IBCLC
Provider Business Mailing Address
First Line : 19201A BEAR VALLEY RD # 1005
Second Line :
City : APPLE VALLEY
State : CA
Zip : 92308-6763
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 170 S GREEN VALLEY PKWY STE 300
Second Line :
City : HENDERSON
State : NV
Zip : 89012-3145
Country : US
Telephone Number : 650-223-4208
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2021
Last Update Date : 03/27/2026

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