Active NPI
Marla Vaughan, RN BSN IBCLC
- Lactation Consultant (Registered Nurse)
- Petaluma, CA
National Provider Identifier
1811289465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Registered Nurse)
- License
- 301963
- Practice address
- 64 Balma LN
Petaluma, CA 94952-9621 - Phone
- (707) 795-3039
- NPI assigned
- May 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 301963 | CA | Primary |
Addresses
Primary practice location
64 Balma LN
Petaluma, CA 94952-9621
Mailing address
64 Balma LN
Petaluma, CA 94952-9621
Phone (707) 795-3039
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
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301963 | CA | MD | Lactation Consultant (Registered Nurse) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305244800000",
"number": "1811289465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 BALMA LN",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949529621",
"telephone_number": "707-795-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 BALMA LN",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949529621",
"telephone_number": "707-795-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "MARLA",
"credential": "RN BSN IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-13",
"last_updated": "2011-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WL0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Lactation Consultant",
"state": "CA",
"license": "301963",
"primary": true
}
],
"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 May 13, 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.