Provider Demographics
NPI:1508512419
Name:MOREIRA SANDOVAL, NATALIE DANIELA (NONE)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:DANIELA
Last Name:MOREIRA SANDOVAL
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 TOPANGA CANYON BLVD STE 309
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2132
Mailing Address - Country:US
Mailing Address - Phone:818-650-1901
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:6355 TOPANGA CANYON BLVD STE 309
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2132
Practice Address - Country:US
Practice Address - Phone:818-650-1901
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician