Mary Marine, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

10218424 Issued in CA

Practice address

20 Allen St
Martinez, CA 94553-2681

Phone

(925) 313-6098

Fax

(925) 313-6599

NPI assigned

Nov 12, 2014

Last updated

Nov 12, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1336545771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 CENTER AVE STE 300",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534634",
            "telephone_number": "925-313-6098",
            "fax_number": "925-313-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ALLEN ST",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945532681",
            "telephone_number": "925-313-6098",
            "fax_number": "925-313-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINE",
        "first_name": "MARY",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "10218424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Dawn Marcellin, OTR
• Jade Emmanny Batungbacal Marcos, MD
• Faith Elizabeth Marcus
• Nezam Massih Mardanzai, RCP
• Kathreena Maila Villanueva Mariano, RN
• Diana Marino Nunez, MD
• Sumiko Maristany, MD
• Cassandra Lynn Mark, PHARMD
• Bradley Kent Marlow, PT
• Ronnie Maquimot Marquez, PT

• Lactation Consultant (Non-RN) in Martinez, CA
• Providers in Martinez, CA by specialty
• Lactation Consultant (Non-RN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.