Individual
AMY AIYEGBUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1601 YGNACIO VALLEY RD, WALNUT CREEK, CA 94598-3122
(925) 939-3000
Mailing address
2732 DOHR ST, BERKELEY, CA 94702-2313
(916) 704-5120
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-303010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L-303010
—
CA
Enumeration date
09/22/2021
Last updated
09/22/2021
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