Healthcare Provider Details

I. General information

NPI: 1154274223
Provider Name (Legal Business Name): NATE NMN PADILLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12850 MUSCATEL ST
HESPERIA CA
92344-5566
US

IV. Provider business mailing address

12850 MUSCATEL ST
HESPERIA CA
92344-5566
US

V. Phone/Fax

Practice location:
  • Phone: 760-949-9202
  • Fax:
Mailing address:
  • Phone: 760-949-9202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: