Healthcare Provider Details

I. General information

NPI: 1952272866
Provider Name (Legal Business Name): KRISTI NOLAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 OLD ORCHARD DR
DANVILLE CA
94526-4331
US

IV. Provider business mailing address

250 ROYAL PALM PL
DANVILLE CA
94526-5341
US

V. Phone/Fax

Practice location:
  • Phone: 415-595-1447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number763828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: