Healthcare Provider Details

I. General information

NPI: 1326373804
Provider Name (Legal Business Name): MAIA SCHOTMAN RN, BS, IBCLC, CEIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3745 DIVISADERO ST APT 3
SAN FRANCISCO CA
94123-1027
US

IV. Provider business mailing address

3745 DIVISADERO ST APT 3
SAN FRANCISCO CA
94123-1027
US

V. Phone/Fax

Practice location:
  • Phone: 424-522-4138
  • Fax:
Mailing address:
  • Phone: 424-522-4138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number22 534232
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: