Healthcare Provider Details

I. General information

NPI: 1154712925
Provider Name (Legal Business Name): NATURAL TRANSITIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 ELM AVE
IMPERIAL BEACH CA
91932-1968
US

IV. Provider business mailing address

255 ELM AVE
IMPERIAL BEACH CA
91932-1968
US

V. Phone/Fax

Practice location:
  • Phone: 619-994-7443
  • Fax:
Mailing address:
  • Phone: 619-994-7443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number174H00000X
License Number StateCA

VIII. Authorized Official

Name: MARY L DUCHARME
Title or Position: PRESIDENT
Credential:
Phone: 619-994-7443