Provider Demographics
NPI:1346034626
Name:SAKAMOTO, NATALIE (CNMT, BCTMB)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:SAKAMOTO
Suffix:
Gender:
Credentials:CNMT, BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 E FLINTLOCK WAY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2705
Mailing Address - Country:US
Mailing Address - Phone:714-715-9194
Mailing Address - Fax:
Practice Address - Street 1:150 PAULARINO AVE STE D170
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3333
Practice Address - Country:US
Practice Address - Phone:714-715-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3054118246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty