Provider Demographics
NPI:1366167892
Name:REIN, TERESA LYNN (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:REIN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5923 CLARK RD STE F
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4866
Mailing Address - Country:US
Mailing Address - Phone:530-287-8222
Mailing Address - Fax:530-237-0420
Practice Address - Street 1:5923 CLARK RD STE F
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4866
Practice Address - Country:US
Practice Address - Phone:530-287-8222
Practice Address - Fax:530-237-0420
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469756163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-26117OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS