Healthcare Provider Details

I. General information

NPI: 1407775786
Provider Name (Legal Business Name): NATASHA KASOZI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9055 BALBOA AVE
SAN DIEGO CA
92123-1509
US

IV. Provider business mailing address

42850 AGENA ST
TEMECULA CA
92592-3200
US

V. Phone/Fax

Practice location:
  • Phone: 909-559-6195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: