Individual
JESSICA BLAIR SIMANDJUNTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
1331 BARTON RD, REDLANDS, CA 92373-1487
(909) 572-8280
Mailing address
1331 BARTON RD, REDLANDS, CA 92373-1487
(909) 572-8280
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
95176001
CA
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-308269
CA
374J00000X
Doula
—
CA
Other
Enumeration date
02/07/2026
Last updated
04/21/2026
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