Individual
ANGELA FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
615 FREDRICKS AVE UNIT 122, OCEANSIDE, CA 92058-1689
(760) 580-8841
Mailing address
615 FREDRICKS AVE UNIT 122, OCEANSIDE, CA 92058-1689
(760) 580-8841
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-136300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
02/06/2019
Last updated
02/06/2019
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