Healthcare Provider Details

I. General information

NPI: 1073347480
Provider Name (Legal Business Name): YANA HAROOTUNIAN-COX IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MEERNAA AVE
FAIRFAX CA
94930-2009
US

IV. Provider business mailing address

135 MEERNAA AVE
FAIRFAX CA
94930-2009
US

V. Phone/Fax

Practice location:
  • Phone: 415-637-2261
  • Fax:
Mailing address:
  • Phone: 415-637-2261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-134373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: