Healthcare Provider Details

I. General information

NPI: 1457536682
Provider Name (Legal Business Name): NICOLE DADDONA N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CORONADO AVE
LONG BEACH CA
90814-1516
US

IV. Provider business mailing address

451 CORONADO AVE
LONG BEACH CA
90814-1516
US

V. Phone/Fax

Practice location:
  • Phone: 503-307-3337
  • Fax: 800-783-0943
Mailing address:
  • Phone: 503-307-3337
  • Fax: 800-783-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNDF909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: