Provider Demographics
NPI:1821365008
Name:RADOJEVIC, NATASHA (PSYD)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:RADOJEVIC
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6973 LINDA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6342
Mailing Address - Country:US
Mailing Address - Phone:858-279-9676
Mailing Address - Fax:858-279-0377
Practice Address - Street 1:7011 LINDA VISTA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6307
Practice Address - Country:US
Practice Address - Phone:858-810-8787
Practice Address - Fax:858-987-5825
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28495103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical