Provider Demographics
NPI:1356536445
Name:NELSON, NATACHA D (DC)
Entity type:Individual
Prefix:DR
First Name:NATACHA
Middle Name:D
Last Name:NELSON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 7TH CT
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-4413
Mailing Address - Country:US
Mailing Address - Phone:310-529-7558
Mailing Address - Fax:
Practice Address - Street 1:49 7TH CT
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-4413
Practice Address - Country:US
Practice Address - Phone:310-529-7558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27687OtherCHIROPRACTIC LICENSE
CAZZZ58488YOtherBLUE SHIELD
CABR415AMedicare PIN