Provider Demographics
NPI:1154096170
Name:CRUZADO, NATALIE PAIGE (NP-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:PAIGE
Last Name:CRUZADO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 E ALESSANDRO BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-6071
Mailing Address - Country:US
Mailing Address - Phone:951-780-1835
Mailing Address - Fax:
Practice Address - Street 1:491 E ALESSANDRO BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-6071
Practice Address - Country:US
Practice Address - Phone:951-780-1835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily