Healthcare Provider Details

I. General information

NPI: 1912897117
Provider Name (Legal Business Name): BREASTFEEDING WITH SARAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6695 LINCOLN ST
PETALUMA CA
94952-9722
US

IV. Provider business mailing address

PO BOX 2787
SEBASTOPOL CA
95473-2787
US

V. Phone/Fax

Practice location:
  • Phone: 707-490-8654
  • Fax:
Mailing address:
  • Phone: 707-490-8654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SARAH HOLLISTER
Title or Position: MANAGER,BREASTFEEDINGWITHSARAH LLC
Credential: RN, IBCLC
Phone: 707-490-8654