Provider Demographics
NPI:1467590133
Name:STEVENSON, NATALIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:
Other - Last Name:STEVENSON-MILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:960 OLD SMITH RD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-8682
Mailing Address - Country:US
Mailing Address - Phone:650-299-2000
Mailing Address - Fax:650-299-4845
Practice Address - Street 1:1150 VETERANS BLVD
Practice Address - Street 2:KAISER PERMANENTE ASPEN BUILDING
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2037
Practice Address - Country:US
Practice Address - Phone:650-299-2000
Practice Address - Fax:650-299-4845
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA442670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP18630Medicare UPIN