Healthcare Provider Details

I. General information

NPI: 1477086312
Provider Name (Legal Business Name): NATHAN ANDREW HATTON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 ELVAS AVE
SACRAMENTO CA
95819-1913
US

IV. Provider business mailing address

2848 CLOVER LN
SACRAMENTO CA
95821-3414
US

V. Phone/Fax

Practice location:
  • Phone: 916-457-8802
  • Fax: 916-457-7609
Mailing address:
  • Phone: 916-214-6795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT292753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: