Provider Demographics
NPI:1245831460
Name:VALE, NATALIE N I
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:N
Last Name:VALE
Suffix:I
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 1:82485 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-4249
Mailing Address - Country:US
Mailing Address - Phone:760-342-8200
Mailing Address - Fax:760-342-8244
Practice Address - Street 1:82485 MILES AVE
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4249
Practice Address - Country:US
Practice Address - Phone:760-342-8200
Practice Address - Fax:760-342-8244
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist