Healthcare Provider Details

I. General information

NPI: 1740810886
Provider Name (Legal Business Name): NATALIE PLINNEKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/20/2020
Certification Date: 01/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 RAGSDALE DR STE 200
MONTEREY CA
93940-7813
US

IV. Provider business mailing address

10 RAGSDALE DR STE 200
MONTEREY CA
93940-7813
US

V. Phone/Fax

Practice location:
  • Phone: 831-644-7485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code136A00000X
TaxonomyRegistered Dietetic Technician
License Number86062245
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: