Individual
INGE SOFIA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
751 S BASCOM AVE, SAN JOSE, CA 95128-2699
(408) 885-6616
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2699
(408) 885-6616
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-87569
CA
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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