Provider Demographics
NPI:1528500667
Name:PADILLA, NATHAN
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:PADILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 WILLOW PASS RD
Mailing Address - Street 2:STE 500
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2408
Mailing Address - Country:US
Mailing Address - Phone:925-692-0090
Mailing Address - Fax:925-692-0091
Practice Address - Street 1:2118 WILLOW PASS RD
Practice Address - Street 2:STE 500
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2408
Practice Address - Country:US
Practice Address - Phone:925-692-0090
Practice Address - Fax:925-692-0091
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor