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NPI Code Detail

MEDICARE: THE CRADLE COMPANY, LLC

MEDICARE: THE CRADLE COMPANY, LLC
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
11041C0700XClinical Social Worker
2174N00000XLactation Consultant (Non-RN)

General Provider Information

NPI Number : 1427661354
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CRADLE COMPANY, LLC
Provider Business Mailing Address
First Line : 1510 E WINDSOR RD
Second Line :
City : GLENDALE
State : CA
Zip : 91205-2724
Country : US
Telephone Number : 323-662-0100
Fax Number :
Provider Business Practice Location Address
First Line : 1510 E WINDSOR RD
Second Line :
City : GLENDALE
State : CA
Zip : 91205-2724
Country : US
Telephone Number : 323-662-0100
Fax Number : 323-662-0101
Authorized Official
Title or Position : OWNER
Name : BRANDI JORDAN
Credential : IBCLC
Telephone Number : 323-662-0100
Provider Enumeration Date : 08/29/2020
Last Update Date : 08/29/2020

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Directions to “THE CRADLE COMPANY, LLC ” Practice Location

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