Individual
DR. NATALIE ELVITA KURNIADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3990 OLD TOWN AVE STE C303, SAN DIEGO, CA 92110-2932
(858) 964-0722
(866) 437-0375
Mailing address
3990 OLD TOWN AVE STE C303, SAN DIEGO, CA 92110-2932
(858) 964-0722
(866) 437-0375
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
32552
CA
103G00000X
Clinical Neuropsychologist
Primary
PSY32552
CA
Other
Enumeration date
07/19/2012
Last updated
02/12/2026
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