Individual
DIANNE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
4472 HERITAGE GLEN LN, SAN DIEGO, CA 92130-2418
(858) 481-2450
Mailing address
4472 HERITAGE GLEN LN, SAN DIEGO, CA 92130-2418
(858) 481-2450
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11294505
CA
Other
Enumeration date
09/06/2014
Last updated
09/06/2014
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