Provider Demographics
NPI:1437427374
Name:RUPPIN, ILANIT (IBCLC)
Entity type:Individual
Prefix:
First Name:ILANIT
Middle Name:
Last Name:RUPPIN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 FRIARS LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-7430
Mailing Address - Country:US
Mailing Address - Phone:408-338-6469
Mailing Address - Fax:
Practice Address - Street 1:2375 FRIARS LN
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-7430
Practice Address - Country:US
Practice Address - Phone:408-338-6469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11144127174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN