=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033092937
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIE WRAY CNS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4867 W SUNSET BLVD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90027-5969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-574-2273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13075 PACIFIC PROMENADE APT 202
-----------------------------------------------------
City | PLAYA VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90094-2109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-722-8658
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364S00000X
-----------------------------------------------------
Taxonomy Name | Clinical Nurse Specialist
-----------------------------------------------------
License Number | 4256
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------