Provider Demographics
NPI:1255223491
Name:DIAMOND, LINDSEY RAE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE
Last Name:DIAMOND
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 1:885 SUTRO AVE
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-2070
Mailing Address - Country:US
Mailing Address - Phone:415-246-8812
Mailing Address - Fax:
Practice Address - Street 1:885 SUTRO AVE
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-2070
Practice Address - Country:US
Practice Address - Phone:415-246-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-318590174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN