Provider Demographics
NPI:1841079738
Name:AYLWARD, REBECCA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:AYLWARD
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 1:1447 26TH ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3029
Mailing Address - Country:US
Mailing Address - Phone:508-472-0070
Mailing Address - Fax:
Practice Address - Street 1:1447 26TH ST UNIT C
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3029
Practice Address - Country:US
Practice Address - Phone:508-472-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026957163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant