Individual provider Active NPI

Tara Stivers, IBCLC

  • Lactation Consultant (Non-RN)
  • Camarillo, CA
National Provider Identifier
1659663623
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
11038193 Issued in CA
Practice address
6930 Quito CT
Camarillo, CA 93012-8296
Phone
(805) 504-3920
NPI assigned
May 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X 11038193 CA Primary

Addresses

Primary practice location

6930 Quito CT
Camarillo, CA 93012-8296

Mailing address

6930 Quito CT
Camarillo, CA 93012-8296
Phone (805) 504-3920

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

State licenses

LicenseStateTypeSpecialty
11038193CAMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1659663623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 QUITO CT",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128296",
            "telephone_number": "805-504-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 QUITO CT",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128296",
            "telephone_number": "805-504-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVERS",
        "first_name": "TARA",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "11038193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.