Provider Demographics
NPI:1467898809
Name:NATARAJAN, VIJAYALAKSHMI (BS, CAS, CMT)
Entity Type:Individual
Prefix:MRS
First Name:VIJAYALAKSHMI
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:F
Credentials:BS, CAS, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4941 ROSELLE CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-7934
Mailing Address - Country:US
Mailing Address - Phone:510-676-5440
Mailing Address - Fax:
Practice Address - Street 1:4941 ROSELLE CMN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536
Practice Address - Country:US
Practice Address - Phone:858-344-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 374J00000X
CA24848064171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula