Provider Demographics
NPI:1306309182
Name:ROMERO, NATANAE (HIS)
Entity type:Individual
Prefix:
First Name:NATANAE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 BREA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4132
Mailing Address - Country:US
Mailing Address - Phone:714-680-9712
Mailing Address - Fax:714-680-9713
Practice Address - Street 1:1370 BREA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4132
Practice Address - Country:US
Practice Address - Phone:714-680-9712
Practice Address - Fax:714-680-9712
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8456237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist