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NPI Code Detail

MEDICARE: REBECCA LAVAE DIEL BS, IBCLC

MEDICARE:   REBECCA LAVAE DIEL  BS, 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
1174N00000XLactation Consultant (Non-RN)11076584CA

General Provider Information

NPI Number : 1285935601
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LAVAE DIEL BS, IBCLC
Provider Business Mailing Address
First Line : 3490 TWIN OAKS CT
Second Line :
City : NAPA
State : CA
Zip : 94558-5226
Country : US
Telephone Number : 707-266-1747
Fax Number :
Provider Business Practice Location Address
First Line : 3490 TWIN OAKS CT
Second Line :
City : NAPA
State : CA
Zip : 94558-5226
Country : US
Telephone Number : 707-266-1747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2010
Last Update Date : 09/05/2013

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Directions to “ REBECCA LAVAE DIEL BS, IBCLC” Practice Location

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