Individual
MISS REBECCA PANCAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2499 CHAUCER PL, THOUSAND OAKS, CA 91362-5301
(805) 906-9411
Mailing address
2499 CHAUCER PL, THOUSAND OAKS, CA 91362-5301
(805) 906-9411
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-60388
CA
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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