Provider Demographics
NPI:1528634870
Name:MENARD, NATASHA ANN (OTD, OTR)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:ANN
Last Name:MENARD
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 SIERRA MORENA AVE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-2830
Mailing Address - Country:US
Mailing Address - Phone:760-805-2831
Mailing Address - Fax:
Practice Address - Street 1:325 KEMPTON ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-5810
Practice Address - Country:US
Practice Address - Phone:619-434-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist