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General NPI Number Information
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NPI Number | 1720915390
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Entity Type | Individual
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Provider Name | GRACIELLA NOEL BAUM
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Gender | Female
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 2580 E MAIN ST STE 101
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City | VENTURA
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State | CA
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Zip | 93003-2624
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Country | US
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Telephone | 805-948-2229
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Fax | 805-652-5384
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Provider Business Mailing Address
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Address Line | 10882 CARLOS ST
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City | VENTURA
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State | CA
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Zip | 93004-1297
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Country | US
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Telephone | 661-904-5560
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Fax | 805-652-5384
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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-19902
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License Number State | CA
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