Individual
MARY LORETTA DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D. IBCLC
Contact information
Practice address
2710 MIDDLEFIELD RD, REDWOOD CITY, CA 94063-3404
(650) 578-7141
(650) 298-6881
Mailing address
2710 MIDDLEFIELD RD, REDWOOD CITY, CA 94063-3404
(650) 578-7141
(650) 298-6881
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
853097
CA
174N00000X
Lactation Consultant (Non-RN)
L-19656
—
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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