Individual provider Active NPI

Anna Lissa S Ladiero

  • Lactation Consultant (Non-RN)
  • San Jacinto, CA
National Provider Identifier
1639021843
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
Practice address
643 Moondance LN
San Jacinto, CA 92583-3664
Phone
(951) 290-8223
NPI assigned
Feb 10, 2026
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Lactation Consultant (Non-RN)Group: 193400000X SINGLE SPECIALTY GROUP 174N00000X Primary

Addresses

Primary practice location

643 Moondance LN
San Jacinto, CA 92583-3664

Mailing address

643 Moondance LN
San Jacinto, CA 92583-3664
Phone (951) 290-8223

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

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1639021843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 MOONDANCE LN",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925833664",
            "telephone_number": "951-290-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 MOONDANCE LN",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925833664",
            "telephone_number": "951-290-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADIERO",
        "first_name": "ANNA LISSA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.