Provider Demographics
NPI:1346626082
Name:POOLE, NATALIA (LMFT)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:POOLE
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1217
Mailing Address - Street 2:
Mailing Address - City:BOULDER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95006-1217
Mailing Address - Country:US
Mailing Address - Phone:650-814-2674
Mailing Address - Fax:
Practice Address - Street 1:6060 GRAHAM HILL RD
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9764
Practice Address - Country:US
Practice Address - Phone:831-219-8324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2025-03-24
Deactivation Date:2022-02-07
Deactivation Code:
Reactivation Date:2022-03-01
Provider Licenses
StateLicense IDTaxonomies
CA153928101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health