Individual provider Active NPI

Evie Katahdin, ND, LAC

  • Naturopath
  • Newport Beach, CA
National Provider Identifier
1710151915
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
ND 33 Issued in CA
Practice address
4121 Westerly PL
Suite 102
Newport Beach, CA 92660-2322
Phone
(949) 660-1399
Fax
(949) 660-1333
NPI assigned
Apr 17, 2008
Last updated
Apr 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 9988 CA
Naturopath 175F00000X ND 33 CA Primary

Addresses

Primary practice location

4121 Westerly PL
Suite 102
Newport Beach, CA 92660-2322

Mailing address

4121 Westerly PL
Suite 102
Newport Beach, CA 92660-2322
Phone (949) 660-1399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC 9988CAMDAcupuncturist
ND 33CAMDNaturopath

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1710151915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 WESTERLY PL",
            "address_2": "SUITE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602322",
            "telephone_number": "949-660-1399",
            "fax_number": "949-660-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 WESTERLY PL",
            "address_2": "SUITE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602322",
            "telephone_number": "949-660-1399",
            "fax_number": "949-660-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATAHDIN",
        "first_name": "EVIE",
        "name_prefix": "Dr.",
        "credential": "ND, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 9988",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND 33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.