MEDICARE: PRETTY MAMA BREASTFEEDING LLC

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1770902009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRETTY MAMA BREASTFEEDING LLC

Provider Business Mailing Address
First Line	:	PO BOX 6565
Second Line	:
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-0565
Country	:	US
Telephone Number	:	908-210-3608
Fax Number	:

Provider Business Practice Location Address
First Line	:	1049 EL MONTE AVE STE C
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-2399
Country	:	US
Telephone Number	:	908-938-5320
Fax Number	:

Authorized Official
Title or Position	:	OWNER CLC
Name	:	MRS. ELIZABETH CHANG
Credential	:	CLC
Telephone Number	:	908-938-5320

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	09/30/2025

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