Healthcare Provider Details

I. General information

NPI: 1861885121
Provider Name (Legal Business Name): REKA GABRIELLA MORVAY IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 01/31/2021
Certification Date: 01/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18600 MAIN ST SUITE 110
HUNTINGTON BEACH CA
92648-1708
US

IV. Provider business mailing address

6011 LEMON AVE APT A
CYPRESS CA
60630
US

V. Phone/Fax

Practice location:
  • Phone: 949-466-2863
  • Fax:
Mailing address:
  • Phone: 949-466-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-28638
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: