MEDICARE: ASHLEY ANDREW IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	L-320353	CA

General Provider Information

NPI Number	:	1114872074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ANDREW IBCLC

Provider Business Mailing Address
First Line	:	3318 LATHROP AVE
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-1110
Country	:	US
Telephone Number	:	818-515-8860
Fax Number	:

Provider Business Practice Location Address
First Line	:	3318 LATHROP AVE
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-1110
Country	:	US
Telephone Number	:	818-515-8860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ ASHLEY ANDREW IBCLC” Practice Location

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