Healthcare Provider Details

I. General information

NPI: 1427650449
Provider Name (Legal Business Name): NATALIE AI SEKIGAWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST
RENO NV
89502-1576
US

IV. Provider business mailing address

17 LINWOOD PL
RENO NV
89509-2629
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-4100
  • Fax: 775-982-4006
Mailing address:
  • Phone: 916-390-5127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number39622-DI-0
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: