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General NPI Number Information
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NPI Number | 1659251361
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Entity Type | Organization
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Legal Business Name | BREAST TIME OF LIFE LLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 27524 SPENCER CT APT 101
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-6806
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Country | US
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Telephone | 818-571-0494
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Fax |
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Provider Business Mailing Address
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Address Line | 14554 ORO GRANDE ST
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City | SYLMAR
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State | CA
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Zip | 91342-4045
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Country | US
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Telephone | 818-571-0494
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAULA INES ROSELLO
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Credential | IBCLC# : L-33582
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Telephone | 818-571-0494
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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 |
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License Number State |
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