Individual
MRS. TANECIA FAVORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CLC
Contact information
Practice address
10144 EPPERSON WAY, SAN DIEGO, CA 92124-3212
(619) 630-5684
Mailing address
10144 EPPERSON WAY, SAN DIEGO, CA 92124-3212
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
937545
TX
163W00000X
Registered Nurse
95265162
CA
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
937545
TX
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
11/10/2022
Last updated
11/13/2023
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