Healthcare Provider Details

I. General information

NPI: 1336494996
Provider Name (Legal Business Name): MARNIE NOEL PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 EMBARCADERO STE 400
OAKLAND CA
94606-5300
US

IV. Provider business mailing address

9537 THUNDERBIRD DR
SAN RAMON CA
94583-3617
US

V. Phone/Fax

Practice location:
  • Phone: 510-871-7628
  • Fax:
Mailing address:
  • Phone: 415-806-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number67179
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: