Healthcare Provider Details

I. General information

NPI: 1558293019
Provider Name (Legal Business Name): EMILZER MARISOL NOVOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1076 HOWARD ST
SAN FRANCISCO CA
94103-2820
US

IV. Provider business mailing address

1076 HOWARD ST FL 2
SAN FRANCISCO CA
94103-2820
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-7802
  • Fax:
Mailing address:
  • Phone: 628-217-7802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number134493
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: