Healthcare Provider Details

I. General information

NPI: 1790912418
Provider Name (Legal Business Name): JOEL NOLAND N.D., LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2009
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 W BURBANK BLVD
BURBANK CA
91506-1348
US

IV. Provider business mailing address

1834 W BURBANK BLVD
BURBANK CA
91506-1348
US

V. Phone/Fax

Practice location:
  • Phone: 818-736-9889
  • Fax: 800-830-0421
Mailing address:
  • Phone: 818-736-9889
  • Fax: 800-830-0421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA0023988
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60186072
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-432
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC-14280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: