Healthcare Provider Details

I. General information

NPI: 1649813114
Provider Name (Legal Business Name): NATALIE C HANSEN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 W OLYMPIC BLVD STE 501
LOS ANGELES CA
90064-1528
US

IV. Provider business mailing address

1268 PALISADES BEACH RD
SANTA MONICA CA
90401-1014
US

V. Phone/Fax

Practice location:
  • Phone: 805-836-2171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: