Healthcare Provider Details

I. General information

NPI: 1558958140
Provider Name (Legal Business Name): RACHEL MARIANNE MOSOLF RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 BOSTON AVE
OAKLAND CA
94602-2906
US

IV. Provider business mailing address

3440 BOSTON AVE
OAKLAND CA
94602-2906
US

V. Phone/Fax

Practice location:
  • Phone: 831-901-4987
  • Fax:
Mailing address:
  • Phone: 831-901-4987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-303629
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: