Provider Demographics
NPI:1952909699
Name:YATES, NATALIE VARNAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:VARNAY
Last Name:YATES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 IRVING CT
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2003
Mailing Address - Country:US
Mailing Address - Phone:415-297-7905
Mailing Address - Fax:
Practice Address - Street 1:200 VINTAGE WAY
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5005
Practice Address - Country:US
Practice Address - Phone:415-892-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA82365OtherCALIFORNIA BOARD OF PHARMACY