Individual provider Active NPI

Jennifer Liza Suffin, IBCLC

  • Lactation Consultant (Non-RN)
  • San Francisco, CA
National Provider Identifier
1003197864
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-33935 Issued in CA
Practice address
66 Prosper St
San Francisco, CA 94114-1609
Phone
(415) 939-7877
NPI assigned
Sep 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-33935 CA Primary

Addresses

Primary practice location

66 Prosper St
San Francisco, CA 94114-1609

Mailing address

1533 Ralston Ave
Burlingame, CA 94010-5109
Phone (415) 939-7877

Other practice location 1

2239 39th Ave
San Francisco, CA 94116-1653
Phone (415) 939-7877

Other identifiers 1

IdentifierTypeStateIssuer
L-33935OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L-33935CAMDLactation Consultant (Non-RN)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1003197864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 RALSTON AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105109",
            "telephone_number": "415-939-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 PROSPER ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141609",
            "telephone_number": "415-939-7877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2239 39th Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941161653",
            "country_code": "US",
            "telephone_number": "415-939-7877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUFFIN",
        "first_name": "JENNIFER",
        "middle_name": "LIZA",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "L-33935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS",
            "identifier": "L-33935",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.