Provider Demographics
NPI:1598273351
Name:LANDEROS, NATHALY DIAZ (LMFT)
Entity type:Individual
Prefix:MS
First Name:NATHALY
Middle Name:DIAZ
Last Name:LANDEROS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NATHALY
Other - Middle Name:
Other - Last Name:AMBRIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT, APCC
Mailing Address - Street 1:2751 NAPA VALLEY CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6216
Mailing Address - Country:US
Mailing Address - Phone:707-299-1643
Mailing Address - Fax:
Practice Address - Street 1:1125 3RD ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3015
Practice Address - Country:US
Practice Address - Phone:707-299-1346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129288106H00000X
CAIMF100717106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist