Healthcare Provider Details

I. General information

NPI: 1609715986
Provider Name (Legal Business Name): NATALIE WADE RN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26322 TOWNE CENTRE DR APT 1326
FOOTHILL RANCH CA
92610-3405
US

IV. Provider business mailing address

26322 TOWNE CENTRE DR APT 1326
FOOTHILL RANCH CA
92610-3405
US

V. Phone/Fax

Practice location:
  • Phone: 818-625-2448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95161579
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: