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Organization

SULA LACTATION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETHANY WOMACK IBCLC (OWNER)
(925) 231-5143
Entity
Organization

Contact information

Practice address
1329 E THOUSAND OAKS BLVD STE 215, THOUSAND OAKS, CA 91362-6265
(925) 231-5143
Mailing address
418 E WILBUR RD APT 207, THOUSAND OAKS, CA 91360-5476
(925) 231-5143

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
133V00000X
Registered Dietitian
163WL0100X
Lactation Consultant (Registered Nurse)
174N00000X
Lactation Consultant (Non-RN)
Primary
225100000X
Physical Therapist
225X00000X
Occupational Therapist

Other

Enumeration date
02/02/2024
Last updated
02/02/2024
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