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General NPI Number Information
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NPI Number | 1871092064
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Entity Type | Individual
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Provider Name | NATALIE PERDOMO VALLE MSN-FNP-C, MPH
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Gender | Female
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 2151 N HARBOR BLVD
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City | FULLERTON
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State | CA
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Zip | 92835-3820
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Country | US
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Telephone | 714-446-5364
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Fax |
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Provider Business Mailing Address
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Address Line | 933 CHAPARRAL DR
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City | WALNUT
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State | CA
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Zip | 91789-4167
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95006773
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License Number State | CA
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