Healthcare Provider Details

I. General information

NPI: 1346192176
Provider Name (Legal Business Name): NATALIE ANN CYHANENKO PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22580 KINGSTON LN
GRASS VALLEY CA
95949-7706
US

IV. Provider business mailing address

22580 KINGSTON LN
GRASS VALLEY CA
95949-7706
US

V. Phone/Fax

Practice location:
  • Phone: 530-268-2800
  • Fax:
Mailing address:
  • Phone: 530-268-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number260015101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: