Jennifer W Rousseau, RN,IBCLC,

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Cotati, CA

NPI 1194352724 · NPPES record last updated Mar 24, 2020

Key facts

NPI
1194352724
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
L31827 (CA)
Practice address
134 Hahn Way
Cotati, CA 94931-5313
Phone
(415) 306-3051
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
L31827CAMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L31827 CA Yes

Addresses

Primary practice location

134 Hahn Way
Cotati, CA 94931-5313

Mailing address

134 Hahn Way
Cotati, CA 94931-5313

Other providers in Cotati, CA

All providers in Cotati, CA · Lactation Consultant (Registered Nurse) in California

Sources for this page

Verify at the official NPI Registry.