Provider Demographics
NPI:1457482713
Name:ANDERSON, NATALIE M (LMFT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 QUAIL ST STE 250
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2734
Mailing Address - Country:US
Mailing Address - Phone:949-222-2848
Mailing Address - Fax:
Practice Address - Street 1:1500 QUAIL ST STE 250
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2734
Practice Address - Country:US
Practice Address - Phone:949-222-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist