Provider Demographics
NPI:1134572662
Name:NEALEIGH, NATALIE ANASTASIA
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ANASTASIA
Last Name:NEALEIGH
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 1:25495 MEDICAL CENTER DR
Mailing Address - Street 2:STE 204
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4903
Mailing Address - Country:US
Mailing Address - Phone:951-698-1901
Mailing Address - Fax:951-698-8232
Practice Address - Street 1:25495 MEDICAL CENTER DR
Practice Address - Street 2:STE 204
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4903
Practice Address - Country:US
Practice Address - Phone:951-698-1901
Practice Address - Fax:951-698-8232
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA53905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant