Individual
NATALIE ANGELE MATTOS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1114 6TH ST, MODESTO, CA 95354-2203
(209) 576-2845
(209) 236-1290
Mailing address
PO BOX 2906, TURLOCK, CA 95381-2906
(209) 892-3111
(209) 892-3112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18095
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1069551
NCCPA CERT #
CA
Enumeration date
11/21/2005
Last updated
03/07/2023
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