Provider Demographics
NPI:1194478461
Name:TALBOT-WHITTAKER, VICTORIA ALICE (IBCLC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ALICE
Last Name:TALBOT-WHITTAKER
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 1:1451 SAN JUAN ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-4646
Mailing Address - Country:US
Mailing Address - Phone:949-939-4667
Mailing Address - Fax:
Practice Address - Street 1:1451 SAN JUAN ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4646
Practice Address - Country:US
Practice Address - Phone:949-939-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-306130174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN