Provider Demographics
NPI:1588930226
Name:POLESCHUK, NATALIA (FNP)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:POLESCHUK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 BALFOUR RD # D-429
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5515
Mailing Address - Country:US
Mailing Address - Phone:415-710-6437
Mailing Address - Fax:
Practice Address - Street 1:3130 BALFOUR RD # D-429
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5515
Practice Address - Country:US
Practice Address - Phone:415-710-6437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF10230463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily