Individual
MRS. TARA STIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
6930 QUITO CT, CAMARILLO, CA 93012-8296
(805) 504-3920
Mailing address
6930 QUITO CT, CAMARILLO, CA 93012-8296
(805) 504-3920
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11038193
CA
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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