Individual provider Active NPI

Amber Dawn Burvall, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • San Diego, CA
National Provider Identifier
1235480294
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
585247 Issued in CA
Practice address
10730 Canyon Lake Dr
San Diego, CA 92131-1214
Phone
(619) 944-4772
Fax
(858) 408-9457
NPI assigned
Sep 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 585247 CA Primary

Addresses

Primary practice location

10730 Canyon Lake Dr
San Diego, CA 92131-1214

Mailing address

10730 Canyon Lake Dr
San Diego, CA 92131-1214
Phone (619) 944-4772

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
585247CAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1348963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1235480294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10730 CANYON LAKE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311214",
            "telephone_number": "619-944-4772",
            "fax_number": "858-408-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 CANYON LAKE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311214",
            "telephone_number": "619-944-4772",
            "fax_number": "858-408-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURVALL",
        "first_name": "AMBER",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-30",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "585247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.