Provider Demographics
NPI:1710022124
Name:GERREN, NATALIE ROSE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ROSE
Last Name:GERREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E COOLEY DR
Mailing Address - Street 2:STE 108 A
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3952
Mailing Address - Country:US
Mailing Address - Phone:951-341-1774
Mailing Address - Fax:909-783-8335
Practice Address - Street 1:1420 E COOLEY DR
Practice Address - Street 2:STE 108 A
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3952
Practice Address - Country:US
Practice Address - Phone:951-341-1774
Practice Address - Fax:909-783-8335
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS22331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical