Healthcare Provider Details

I. General information

NPI: 1891810388
Provider Name (Legal Business Name): NOELLE THOMAS M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NOEL THOMAS SICK M.D.

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6293
US

IV. Provider business mailing address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6293
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-5000
  • Fax: 707-253-5097
Mailing address:
  • Phone: 408-299-4841
  • Fax: 408-299-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA76591
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: