Healthcare Provider Details

I. General information

NPI: 1831680339
Provider Name (Legal Business Name): NATASHA GINNATY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3919 W HAZARD AVE
SANTA ANA CA
92703-2625
US

IV. Provider business mailing address

5405 GARDEN GROVE BLVD STE 100
WESTMINSTER CA
92683-1887
US

V. Phone/Fax

Practice location:
  • Phone: 714-713-5272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: