Individual
KATRINA HENNESSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC, RLC
Contact information
Practice address
76 PARK ESSEX PL, SAN JOSE, CA 95136-2517
(408) 629-4844
Mailing address
76 PARK ESSEX PL, SAN JOSE, CA 95136-2517
(408) 629-4844
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
458808
CA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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