Healthcare Provider Details

I. General information

NPI: 1811316029
Provider Name (Legal Business Name): SARAH FURLANO, IBCLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 FOREST AVE
SANTA CRUZ CA
95062-2214
US

IV. Provider business mailing address

225 FOREST AVENUE
SANTA CRUZ CA
95062
US

V. Phone/Fax

Practice location:
  • Phone: 831-227-4022
  • Fax:
Mailing address:
  • Phone: 831-227-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number11067392
License Number State

VIII. Authorized Official

Name: SARAH KATHRYN FULOP-FURLANO
Title or Position: LACTATION CONSULTANT
Credential: IBCLC
Phone: 831-227-4022