Healthcare Provider Details
I. General information
NPI: 1750267688
Provider Name (Legal Business Name): NOVAHAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
333 1ST ST
SAN FRANCISCO CA
94105-2687
US
IV. Provider business mailing address
PO BOX 786
BETHEL ISLAND CA
94511-0786
US
V. Phone/Fax
- Phone: 707-567-1674
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPHINE
HARTS
Title or Position: NP
Credential:
Phone: 323-676-1281