Provider Demographics
NPI:1215701461
Name:HERRIOTT, NATALIE MARIE (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:HERRIOTT
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2558
Mailing Address - Country:US
Mailing Address - Phone:949-478-0109
Mailing Address - Fax:888-595-5286
Practice Address - Street 1:4000 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2558
Practice Address - Country:US
Practice Address - Phone:949-478-0109
Practice Address - Fax:888-595-5286
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist