Individual
BRANDI S GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1474 VIA CORALLA, SAN LORENZO, CA 94580
(510) 372-4481
Mailing address
1474 VIA CORALLA, SAN LORENZO, CA 94580-2729
(510) 372-4481
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11130398
CA
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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