Provider Demographics
NPI:1295150530
Name:VALLOT, NATALIE LAUREN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:LAUREN
Last Name:VALLOT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:LAUREN
Other - Last Name:GUDERJAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3445 BRIERTOWN CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4010
Mailing Address - Country:US
Mailing Address - Phone:530-840-4636
Mailing Address - Fax:
Practice Address - Street 1:2805 J ST STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4307
Practice Address - Country:US
Practice Address - Phone:916-231-8755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000161367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered