Provider Demographics
NPI:1841544020
Name:TROUSDALE, NATALIE CONSIGLIERI (LAC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CONSIGLIERI
Last Name:TROUSDALE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 GOUGH STREET
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:408-313-9426
Mailing Address - Fax:
Practice Address - Street 1:379 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4420
Practice Address - Country:US
Practice Address - Phone:415-633-6581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14985171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist