Healthcare Provider Details

I. General information

NPI: 1992402762
Provider Name (Legal Business Name): REBECCA MARIE SCHEIBLAUER RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 PAUL MINNIE AVE
SANTA CRUZ CA
95062
US

IV. Provider business mailing address

2404 PAUL MINNIE AVE
SANTA CRUZ CA
95062
US

V. Phone/Fax

Practice location:
  • Phone: 734-846-9016
  • Fax:
Mailing address:
  • Phone: 734-846-9016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberIBCLCL-60567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: