Individual
NATHANIEL SOUN PRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3525 PRESLEY AVE, RIVERSIDE, CA 92507-4453
(951) 782-2400
Mailing address
3525 PRESLEY AVE, RIVERSIDE, CA 92507-4453
(951) 782-2400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
03/03/2026
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