Healthcare Provider Details

I. General information

NPI: 1528828860
Provider Name (Legal Business Name): NATALIA CAMACHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 AUTO CENTER DR
WATSONVILLE CA
95076-3727
US

IV. Provider business mailing address

567 AUTO CENTER DR
WATSONVILLE CA
95076-3727
US

V. Phone/Fax

Practice location:
  • Phone: 831-724-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15021
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number141768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: