Provider Demographics
NPI:1932672102
Name:VELDKAMP, NATALIE THERESA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:THERESA
Last Name:VELDKAMP
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:THERESA
Other - Last Name:EPPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:169 SAXONY RD STE 111
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6779
Mailing Address - Country:US
Mailing Address - Phone:619-800-3676
Mailing Address - Fax:
Practice Address - Street 1:169 SAXONY RD STE 111
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6779
Practice Address - Country:US
Practice Address - Phone:619-800-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123674101YM0800X, 106H00000X
CA110331106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health