Provider Demographics
NPI:1437729423
Name:NATAN, KATHY VUONG (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:VUONG
Last Name:NATAN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:NGOC
Other - Last Name:VUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2450 ASHBY AVE RM 1190
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 ASHBY AVE RM 1190
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2067
Practice Address - Country:US
Practice Address - Phone:510-204-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95159940163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant