Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Courtney Marie Wallace, RN, PHN, IBCLC

Individual provider Lactation Consultant (Registered Nurse) · NPI 1710798285

Courtney Marie Wallace, RN, PHN, IBCLC is a Lactation Consultant (Registered Nurse) in Ventura, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2025
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

363 Barry Dr
Ventura, CA 93001-1495
Phone: (805) 798-1596
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Lactation Consultant (Registered Nurse) (primary) Taxonomy 163WL0100X · Licence 821163 (CA)

Record details

NPI number1710798285
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN , PHN , IBCLC
Sole proprietorYes
NPI enumeratedJanuary 15, 2025
Last updated in NPPESJanuary 15, 2025
Certification dateJanuary 15, 2025

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