Healthcare Provider Details

I. General information

NPI: 1861329344
Provider Name (Legal Business Name): CHANTEL RODRIGUEZ IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 E MAIN ST STE 101
VENTURA CA
93003-2624
US

IV. Provider business mailing address

732 FOREST PARK BLVD APT 222
OXNARD CA
93036-5434
US

V. Phone/Fax

Practice location:
  • Phone: 805-948-2229
  • Fax:
Mailing address:
  • Phone: 805-760-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-315262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: