Individual
TERESA ANN MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
4443 30TH ST STE 205, SAN DIEGO, CA 92116-4291
(619) 312-1832
Mailing address
9728 MARILLA DR UNIT 205, LAKESIDE, CA 92040-2853
(858) 216-6257
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
784994
CA
Other
Enumeration date
02/04/2019
Last updated
03/11/2019
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