Individual
MRS. LEILANI WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCD(DONA),CLC
Contact information
Practice address
13210 MEDALLION LN, LAKESIDE, CA 92040-5019
(619) 922-0808
(619) 328-5995
Mailing address
13210 MEDALLION LN, LAKESIDE, CA 92040-5019
(619) 922-0808
(619) 328-5995
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11155412
CA
374J00000X
Doula
—
—
Other
Enumeration date
10/05/2010
Last updated
11/02/2011
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