Provider Demographics
NPI:1467664409
Name:D'AMICO, GRETA HAUCK (ND)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:HAUCK
Last Name:D'AMICO
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 1:2215 SPANISH CORRAL LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-9432
Mailing Address - Country:US
Mailing Address - Phone:530-885-1713
Mailing Address - Fax:
Practice Address - Street 1:1449 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5008
Practice Address - Country:US
Practice Address - Phone:530-823-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-21175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath