Healthcare Provider Details

I. General information

NPI: 1144111527
Provider Name (Legal Business Name): NATALIA ETTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 HIGHLAND AVE
NEEDHAM MA
02494-3036
US

IV. Provider business mailing address

1951 CORTEREAL AVE
OAKLAND CA
94611-2631
US

V. Phone/Fax

Practice location:
  • Phone: 781-752-6857
  • Fax:
Mailing address:
  • Phone: 408-724-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: