Healthcare Provider Details

I. General information

NPI: 1932991460
Provider Name (Legal Business Name): NATALIE GRACE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 N B ST
SACRAMENTO CA
95811-0326
US

IV. Provider business mailing address

1103 N B ST
SACRAMENTO CA
95811-0326
US

V. Phone/Fax

Practice location:
  • Phone: 916-378-8266
  • Fax:
Mailing address:
  • Phone: 916-378-8266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE162052
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: