Provider Demographics
NPI:1477790319
Name:OROSCO, NATALIE OLIVIA
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:OLIVIA
Last Name:OROSCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15835 AVENIDA VENUSTO
Mailing Address - Street 2:APT 426
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-3318
Mailing Address - Country:US
Mailing Address - Phone:414-736-1287
Mailing Address - Fax:
Practice Address - Street 1:15835 AVENIDA VENUSTO
Practice Address - Street 2:APT 426
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-3318
Practice Address - Country:US
Practice Address - Phone:414-736-1287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation