Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1075 | CA |
NPI | 1043653074 |
---|---|
Provider Name | Natalie Pedro |
First Address | San Rafael, CA 94901-3441 |
Second Address | Mill Valley, CA 94941-3034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 21/04/2020 |