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General NPI Number Information
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NPI Number | 1124909585
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Entity Type | Individual
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Provider Name | VICTORIA JAYNE HALLS
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Gender | Female
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 433 ENCLAVE CIR APT 205
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City | COSTA MESA
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State | CA
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Zip | 92626-7088
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Country | US
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Telephone | 832-879-8019
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 W CARROLL AVE
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City | CHICAGO
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State | IL
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Zip | 60612-2501
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Country | US
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Telephone | 630-886-4978
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-315652
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License Number State | CA
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