Healthcare Provider Details

I. General information

NPI: 1265928386
Provider Name (Legal Business Name): SABRINA GRAVITZ RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N BRENT ST
VENTURA CA
93003-2809
US

IV. Provider business mailing address

518 GARDEN ST
SANTA BARBARA CA
93101-1696
US

V. Phone/Fax

Practice location:
  • Phone: 888-898-3806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95154918
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-305758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: