Provider Demographics
NPI:1093515447
Name:ANDERSON CHEVALIER, NATASCHA
Entity type:Individual
Prefix:
First Name:NATASCHA
Middle Name:
Last Name:ANDERSON CHEVALIER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 REGAL APT 436
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3523
Mailing Address - Country:US
Mailing Address - Phone:949-466-1763
Mailing Address - Fax:
Practice Address - Street 1:92 ARGONAUT STE 275
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4129
Practice Address - Country:US
Practice Address - Phone:949-466-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86321225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty