Healthcare Provider Details

I. General information

NPI: 1134057227
Provider Name (Legal Business Name): LAURA MORETTA RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 916-694-6631
  • Fax:
Mailing address:
  • Phone: 916-694-6631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-320817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: