Provider Demographics
NPI:1992576748
Name:FLORES, NATHALIE MARIE
Entity type:Individual
Prefix:MS
First Name:NATHALIE
Middle Name:MARIE
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20433 CAJALCO RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-8176
Mailing Address - Country:US
Mailing Address - Phone:760-262-7911
Mailing Address - Fax:
Practice Address - Street 1:20433 CAJALCO RD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-8176
Practice Address - Country:US
Practice Address - Phone:760-262-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst