Healthcare Provider Details

I. General information

NPI: 1609786409
Provider Name (Legal Business Name): NATALY PRECIADO CPT I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 N LAKE AVE
PASADENA CA
91104-3757
US

IV. Provider business mailing address

3553 SABINA ST
LOS ANGELES CA
90023-1721
US

V. Phone/Fax

Practice location:
  • Phone: 323-768-1261
  • Fax:
Mailing address:
  • Phone: 323-768-1261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT-02591504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: