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General NPI Number Information
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NPI Number | 1689266611
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Entity Type | Individual
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Provider Name | AILEEN MORADIAN RN, MSN-ED, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 9961 SIERRA AVE
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City | FONTANA
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State | CA
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Zip | 92335-6720
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Country | US
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Telephone | 909-703-3079
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Fax | 909-703-3582
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Provider Business Mailing Address
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Address Line | 4517 RANGER AVE
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City | EL MONTE
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State | CA
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Zip | 91731-1527
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Country | US
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Telephone | 909-703-3079
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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-106665
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License Number State | CA
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