Provider Demographics
NPI:1447311147
Name:MASSEY, SONJA ELIZABETH (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:ELIZABETH
Last Name:MASSEY
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 1:982 RANSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-5325
Mailing Address - Country:US
Mailing Address - Phone:831-402-1666
Mailing Address - Fax:831-657-9702
Practice Address - Street 1:529 CENTRAL AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2732
Practice Address - Country:US
Practice Address - Phone:831-402-1666
Practice Address - Fax:831-657-9702
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405202163W00000X
CA198-14908163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse