Healthcare Provider Details

I. General information

NPI: 1679363741
Provider Name (Legal Business Name): VALERIE CLAXTON RN, BSN, IBCLC, ICCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 TIOGA DR
LODI CA
95242-2649
US

IV. Provider business mailing address

327 TIOGA DR
LODI CA
95242-2649
US

V. Phone/Fax

Practice location:
  • Phone: 717-330-6364
  • Fax:
Mailing address:
  • Phone: 717-330-6364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95041234
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-316832
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number95041234
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number95041234
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number95041234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: