Doctor Name: | RANDY NATER |
NPI Number: | 1225264401 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LCS28655 |
Business Practice Address: | 233 Baseline Rd 400 La Verne, CA - 917502353 |
Business Phone Number: | 9095932581 |
Business Fax Number: | |
Mailing Address: | 233 West Baseline Road, Box 400, LA VERNE |
State: | CA |
Postal Code: | 91750 |
Phone Number: | 9098332986 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2009 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS28655 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |