Healthcare Provider Details

I. General information

NPI: 1932003282
Provider Name (Legal Business Name): AMY LYNN CIOTOLA RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 DIABLO DOWNS DR
CLAYTON CA
94517-1567
US

IV. Provider business mailing address

918 DIABLO DOWNS DR
CLAYTON CA
94517-1567
US

V. Phone/Fax

Practice location:
  • Phone: 925-765-0829
  • Fax:
Mailing address:
  • Phone: 925-765-0829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number776005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: