Breanne Booren, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L126580

Practice address

13164 Old Sycamore Dr
San Diego, CA 92128-4043

Phone

(303) 525-8138

NPI assigned

Aug 5, 2022

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

Other names 1

• Bre Booren Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1649907957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13164 OLD SYCAMORE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284043",
            "telephone_number": "303-525-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13164 OLD SYCAMORE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284043",
            "telephone_number": "303-525-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOREN",
        "first_name": "BREANNE",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L126580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRE",
            "last_name": "BOOREN",
            "credential": "IBCLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Kenneth Booth

• Lactation Consultant (Non-RN) in San Diego, CA
• Providers in San Diego, 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 Aug 5, 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.