Provider Demographics
NPI:1649897968
Name:NATHO, AMBER M
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:NATHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 WALNUT ST STE G
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-3611
Mailing Address - Country:US
Mailing Address - Phone:530-527-7893
Mailing Address - Fax:530-527-0766
Practice Address - Street 1:1850 WALNUT ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3611
Practice Address - Country:US
Practice Address - Phone:530-527-7893
Practice Address - Fax:530-527-0766
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10523101YA0400X
CAASW1233761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)