Provider Demographics
NPI:1932909066
Name:FITZPATRICK, CAROLINE LACEY (IBCLC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:LACEY
Last Name:FITZPATRICK
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 1:526 VIA DE LA VALLE UNIT J
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2478
Mailing Address - Country:US
Mailing Address - Phone:267-582-4592
Mailing Address - Fax:
Practice Address - Street 1:526 VIA DE LA VALLE UNIT J
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2478
Practice Address - Country:US
Practice Address - Phone:267-582-4592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-317513163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant