Provider Demographics
NPI:1285361626
Name:OHEA, CARLEE MARISSA (IBCLC)
Entity type:Individual
Prefix:
First Name:CARLEE
Middle Name:MARISSA
Last Name:OHEA
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 1:270 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OAK VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:93022-9418
Mailing Address - Country:US
Mailing Address - Phone:310-386-4319
Mailing Address - Fax:
Practice Address - Street 1:147 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2809
Practice Address - Country:US
Practice Address - Phone:805-948-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-152706163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant