Healthcare Provider Details

I. General information

NPI: 1285087916
Provider Name (Legal Business Name): NATASHA FOSTER BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 07/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 SPRING DR
SPRING VALLEY CA
91977-1030
US

IV. Provider business mailing address

7366 PARKWAY DR APT 303
LA MESA CA
91942-1843
US

V. Phone/Fax

Practice location:
  • Phone: 619-797-1090
  • Fax:
Mailing address:
  • Phone: 619-376-0274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: