Lynn Thiebaud, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

502516 Issued in CA

Practice address

1040 Colusa Ave
Berkeley, CA 94707-2516

Phone

(510) 529-5514

NPI assigned

Feb 7, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1326310285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 COLUSA AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072516",
            "telephone_number": "510-529-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 COLUSA AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072516",
            "telephone_number": "510-529-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEBAUD",
        "first_name": "LYNN",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "502516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Redwood Clinic
• The West Oakland Health Council
• The West Oakland Health Council
• The Wright Institute
• Tamara Thebert, M.F.T.
• Natalie Elise Thiel
• Thomas K. Stern, M.D. P.C.
• Thomas K. Stern, M.D. P.C.
• Angelyn R Thomas, M.D.
• Connie Sue Thomas, RN

• Lactation Consultant (Registered Nurse) in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Lactation Consultant (Registered Nurse) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.