Healthcare Provider Details

I. General information

NPI: 1336857978
Provider Name (Legal Business Name): MONICA RALSTON ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 11/14/2022
Certification Date: 11/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD STE 200
MILL VALLEY CA
94941-3055
US

IV. Provider business mailing address

49 CRESTWOOD DR
SAN RAFAEL CA
94901-1148
US

V. Phone/Fax

Practice location:
  • Phone: 415-569-4470
  • Fax:
Mailing address:
  • Phone: 503-577-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: