Healthcare Provider Details

I. General information

NPI: 1881474500
Provider Name (Legal Business Name): NATALIE ROSE GREENBERG ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 09/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 ARENAS ST
LA JOLLA CA
92037-5302
US

IV. Provider business mailing address

419 ARENAS ST
LA JOLLA CA
92037-5302
US

V. Phone/Fax

Practice location:
  • Phone: 619-254-5013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1443
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: