Sandra Maria Davis Hathaway, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

11141184 Issued in CA

Practice address

705 E Artesia Blvd
Long Beach, CA 90805-1439

Phone

(562) 674-8500

NPI assigned

Feb 7, 2012

Sex

Female

Sole proprietor

Yes

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": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1720350614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 E 72ND ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908051035",
            "telephone_number": "562-674-8500",
            "fax_number": "562-422-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E ARTESIA BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908051439",
            "telephone_number": "562-674-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS HATHAWAY",
        "first_name": "SANDRA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "11141184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Younan DDS Inc.
• David Zamorano, M.D., Inc.
• Charles David Jr., PTA
• Dawn Davidson
• Rita Davies, OT, CHT
• Rachel Denise Davis-Berry, LVN
• Constance J Davis-Huegel
• Emani Davis-Moore
• Pam Davis-Washington, RDA
• Thaius Davis-Welch

• Lactation Consultant (Registered Nurse) in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Lactation Consultant (Registered Nurse) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.