Healthcare Provider Details

I. General information

NPI: 1306757109
Provider Name (Legal Business Name): NATALIE YEZI MAO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 BRADVIEW DR
SACRAMENTO CA
95827-9703
US

IV. Provider business mailing address

3727 BRADVIEW DR
SACRAMENTO CA
95827-9746
US

V. Phone/Fax

Practice location:
  • Phone: 916-572-6162
  • Fax: 916-542-2837
Mailing address:
  • Phone: 916-572-6162
  • Fax: 916-542-2837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310676
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: