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General NPI Number Information
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NPI Number | 1598455578
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Entity Type | Individual
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Provider Name | KRISTIE COLLEEN KIRKLEY-SANTOYO IBCLC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 1250 6TH ST
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City | SANTA MONICA
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State | CA
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Zip | 90401-1633
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Country | US
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Telephone | 310-825-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 2438 N NAOMI ST
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City | BURBANK
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State | CA
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Zip | 91504-3231
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Country | US
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Telephone | 213-219-7814
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-307316
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License Number State | CA
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