Provider Demographics
NPI:1427554385
Name:OKUHARA, NATALIE ANN
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:OKUHARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANN
Other - Last Name:OKUHARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 KATHY CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-1090
Mailing Address - Country:US
Mailing Address - Phone:916-710-1830
Mailing Address - Fax:
Practice Address - Street 1:1807 BAY RD
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1312
Practice Address - Country:US
Practice Address - Phone:650-289-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA104203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program