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General NPI Number Information
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NPI Number | 1134048184
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Entity Type | Organization
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Legal Business Name | THE OTHER SIDE OF BIRTH
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 3169 CANYON VIEW DR
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City | SANTA CLARA
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State | UT
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Zip | 84765-5150
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Country | US
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Telephone | 385-444-5267
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Fax |
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Provider Business Mailing Address
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Address Line | 3169 CANYON VIEW DR
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City | SANTA CLARA
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State | UT
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Zip | 84765-5150
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Country | US
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Telephone | 385-444-5267
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHLOE GONZALEZ
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Credential | RN, BSN, IBCLC
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Telephone | 385-444-5267
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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 |
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License Number State |
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