Provider Demographics
NPI:1417664400
Name:MACLEAY, NATASHA WANDA (ND)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:WANDA
Last Name:MACLEAY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 CAMINO DEL MAR STE 2
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2551
Mailing Address - Country:US
Mailing Address - Phone:860-309-1216
Mailing Address - Fax:
Practice Address - Street 1:1412 CAMINO DEL MAR STE 2
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2551
Practice Address - Country:US
Practice Address - Phone:860-309-1216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1384175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath