Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-309 | CA |
NPI | 1073845772 |
---|---|
Provider Name | Dr. Marjorie Renee Matson |
First Address | Newcastle, CA 95658-9375 |
Second Address | Rocklin, CA 95765-5874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2010 |
Last Update Date | 04/02/2010 |