Provider Demographics
NPI:1972671857
Name:HARDING, NADIA MARIE (LAC)
Entity Type:Individual
Prefix:
First Name:NADIA MARIE
Middle Name:
Last Name:HARDING
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10030 LIMERICK AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311
Mailing Address - Country:US
Mailing Address - Phone:818-882-9765
Mailing Address - Fax:818-882-9765
Practice Address - Street 1:10030 LIMERICK AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311
Practice Address - Country:US
Practice Address - Phone:818-882-9765
Practice Address - Fax:818-882-9765
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6992171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9770833Medicaid