Provider Demographics
NPI:1376037028
Name:LANZARIN, NATALIE EMILIA (FNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:EMILIA
Last Name:LANZARIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:EMILIA
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 BATES AVE SUITE B
Mailing Address - Street 2:SUITE B
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-787-9416
Mailing Address - Fax:925-608-5188
Practice Address - Street 1:2500 ALHAMBRA AVE
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3156
Practice Address - Country:US
Practice Address - Phone:925-787-9416
Practice Address - Fax:925-608-5188
Is Sole Proprietor?:No
Enumeration Date:2018-06-17
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily