MAYA RADOCCIA-KENNEN (NPI# 1053797159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053797159 |
| Entity Type | Individual |
| Full Name | MAYA RADOCCIA-KENNEN |
| Credential | IBCLC |
| Practice Address |
510 Main St Clarkdale AZ 86324 |
| Mailing Address |
Po Box 225 Clarkdale AZ 86324-0225 |
| Practice Telephone | 9283013274 |
| Mailing Telephone | 9283013274 |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174N00000X | Lactation Consultant, Non-RN | Other Service Providers |
| Street Address |
510 MAIN ST |
| City | CLARKDALE |
| State | AZ |
| Zip Code | 86324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497038251 | Taxi and Touring Sedona | Private Vehicle | 516 2nd North Street, Clarkdale, AZ 86324 | 2011-09-27 |
| 1972898831 | Four Directions LLC | Respite Care | 540 E Raven Hill Rd, Clarkdale, AZ 86324 | 2011-06-17 |
| 1861684110 | Clarkdale-jerome Elementary School District #3 | Local Education Agency (LEA) | 1615 Main St, Clarkdale, AZ 86324 | 2007-08-10 |
| 1801879697 | David Richard Moore | Chiropractor | 915 Main St, Clarkdale, AZ 86324-0667 | 2005-11-25 |
| 1659346179 | Kathleen Ann Berger | Physical Therapist | 26 N 10th St., Clarkdale, AZ 86324-1146 | 2006-02-19 |
| 1659694297 | Tracy Reilly | Speech-Language Pathologist | 675 Cliffside Dr, Clarkdale, AZ 86324-3142 | 2010-03-10 |
| 1568810307 | Annie Ngon | Speech-Language Pathologist | 628 Bootleg Rd, Clarkdale, AZ 86324-3326 | 2016-06-02 |
| 1023666997 | Michelle Murie | Foster Care Agency | 567 Whistle Stop Rd, Clarkdale, AZ 86324-3374 | 2019-09-03 |
| 1932424314 | Kristin Dunford Stump | Nurse Practitioner | 601 Black Hills Dr, Clarkdale, AZ 86324-3736 | 2010-03-29 |
| 1720597941 | Trever D Davis | Counselor | 771 Alfonse Rd, Clarkdale, AZ 86324-7402 | 2017-09-20 |
| Find all providers in zip 86324 | ||||
| Taxonomy Code | 174N00000X |
| Grouping | Other Service Providers |
| Classification | Lactation Consultant, Non-RN |
| An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization. |
| Notes: Source: National Uniform Claim Committee [1/1/2011: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894379 | Rhegan Riane Derfus | Lactation Consultant, Non-RN | 3865 Barraco Dr, Sierra Vista, AZ 85650-4211 | 2020-05-28 |
| 1366072266 | Mirishka Elizabeth Gill | Lactation Consultant, Non-RN | 139 N 85th Pl, Mesa, AZ 85207-8669 | 2020-01-19 |
| 1063073963 | Heather Marie Evans | Lactation Consultant, Non-RN | 9233 E Neville Ave Unit 1112, Mesa, AZ 85209-1511 | 2019-06-22 |
| 1639642861 | Emily Barnes | Lactation Consultant, Non-RN | 285 N Kenneth Pl, Chandler, AZ 85226-2944 | 2019-01-10 |
| 1699269878 | Sarah Grace Clay | Lactation Consultant, Non-RN | 8400 S Kyrene Rd Ste 125, Tempe, AZ 85284-2172 | 2018-06-20 |
| 1437670635 | Kimberly Dawn Moore-salas | Lactation Consultant, Non-RN | 8400 S Kyrene Rd Ste 126, Tempe, AZ 85284-2172 | 2017-06-28 |
| 1033653456 | Carol Kidd | Lactation Consultant, Non-RN | 3424 W Tanya Trl, Phoenix, AZ 85086-4328 | 2016-12-05 |
| 1043764582 | Anna Elizabeth Neuman Singleton | Lactation Consultant, Non-RN | 3445 N King St, Flagstaff, AZ 86004-2027 | 2016-08-13 |
| 1508319054 | Holistic Lactation LLC | Lactation Consultant, Non-RN | 4717 N 33rd Pl, Phoenix, AZ 85018-3316 | 2016-08-02 |
| 1073972915 | Marylou Sandoval | Lactation Consultant, Non-RN | 3536 W San Juan Ave, Phoenix, AZ 85019-4514 | 2016-02-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.