Basic Information
Provider Information
NPI: 1124505870
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JARAMILLO
FirstName: NATALIA
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: COUNSELOR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3250 WILSHIRE BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90010
CountryCode: US
TelephoneNumber: 3233613849
FaxNumber:  
Practice Location
Address1: 3250 WILSHIRE BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900101577
CountryCode: US
TelephoneNumber: 3233613849
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2018
LastUpdateDate: 07/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
390200000X CAY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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