Provider Demographics
NPI:1457133795
Name:UMPHREY, NATALIE (RRT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:UMPHREY
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 GOBLE LN UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-2281
Mailing Address - Country:US
Mailing Address - Phone:505-604-1289
Mailing Address - Fax:
Practice Address - Street 1:2738 GOBLE LN UNIT 2
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-2281
Practice Address - Country:US
Practice Address - Phone:505-604-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345122279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist