Provider Demographics
NPI:1316339724
Name:CUTIN-BOTTOMLEY, SHARON (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CUTIN-BOTTOMLEY
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 1:6654 BLEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE BALBOA
Mailing Address - State:CA
Mailing Address - Zip Code:91406-6010
Mailing Address - Country:US
Mailing Address - Phone:818-388-1299
Mailing Address - Fax:
Practice Address - Street 1:6654 BLEWETT AVE
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-6010
Practice Address - Country:US
Practice Address - Phone:818-388-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-22
Last Update Date:2015-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-56587163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant