Healthcare Provider Details

I. General information

NPI: 1598626954
Provider Name (Legal Business Name): NOELLE ANGELIQUE MASTRILI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US

IV. Provider business mailing address

450 BROADWAY ST 2ND FLOOR - SLEEP CLINIC
REDWOOD CITY CA
94063-3132
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-5276
  • Fax:
Mailing address:
  • Phone: 650-723-6601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36021
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36021
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY36021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: