Individual provider Active NPI

Sarah Roseanne Hollister, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Petaluma, CA
National Provider Identifier
1548021504
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
743006 Issued in CA
Practice address
6695 Lincoln St
Petaluma, CA 94952-9722
Phone
(707) 490-8654
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 743006 CA Primary
Doula 374J00000X

Addresses

Primary practice location

6695 Lincoln St
Petaluma, CA 94952-9722

Mailing address

PO Box 2787
Sebastopol, CA 95473-2787
Phone (707) 490-8654

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
743006CAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Breastfeeding With Sarah LLC Lactation Consultant CurrentSince Jul 13, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1548021504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2787",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954732787",
            "telephone_number": "707-490-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6695 LINCOLN ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529722",
            "telephone_number": "707-490-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLISTER",
        "first_name": "SARAH",
        "middle_name": "ROSEANNE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "743006",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.