Organization
4TH TRIMESTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA KENLOW IBCLC (LACTATION CONSULTANT)
(562) 760-3407
Entity
Organization
Contact information
Practice address
12443 GRADWELL ST, LAKEWOOD, CA 90715-2314
(562) 760-3407
Mailing address
12443 GRADWELL ST, LAKEWOOD, CA 90715-2314
(562) 760-3407
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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