Provider Demographics
NPI:1154541977
Name:PERRY-MATZKE, NATALIE K
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:K
Last Name:PERRY-MATZKE
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:P.O. BOX 5487
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94524
Mailing Address - Country:US
Mailing Address - Phone:925-798-7250
Mailing Address - Fax:925-798-3359
Practice Address - Street 1:2090 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4902
Practice Address - Country:US
Practice Address - Phone:925-685-9550
Practice Address - Fax:925-685-7005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP0501060818101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)