Jina M Ethelbah, ND
Individual provider Active NPI Naturopath · Oakland, AZ
NPI 1144607482 · NPPES record last updated May 6, 2015
Key facts
- NPI
- 1144607482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- ND703 (CA)
- Practice address
- 4333 Piedmont Ave
Oakland, AZ 94611 - Phone
- (415) 470-4184
- NPI assigned
- May 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND703 | CA | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | ND703 | CA | Yes |
Addresses
Primary practice location
4333 Piedmont Ave
Oakland, AZ 94611
Mailing address
5814 N Cattle Track Rd
Scottsdale, AZ 85250-6027
Phone (928) 221-3443
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.