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General NPI Number Information
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NPI Number | 1255901799
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Entity Type | Individual
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Provider Name | NATALIA MARISSA ROBERTS FNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 2720 LOW CT
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City | FAIRFIELD
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State | CA
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Zip | 94534-9771
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Country | US
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Telephone | 707-427-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 51 PELLERIA DR
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-1432
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Country | US
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Telephone | 510-861-9063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95209937
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP95017170
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License Number State | CA
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