Provider Demographics
NPI:1922874353
Name:NASSIRI, NATALIE PADILLA
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:PADILLA
Last Name:NASSIRI
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 1:3631 TRUXEL RD # 1037
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3604
Mailing Address - Country:US
Mailing Address - Phone:510-200-8334
Mailing Address - Fax:
Practice Address - Street 1:5740 WINDMILL WAY STE 8
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1379
Practice Address - Country:US
Practice Address - Phone:510-200-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist