Healthcare Provider Details

I. General information

NPI: 1982529350
Provider Name (Legal Business Name): NOEMI CELIO AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LOS GAMOS DR STE 120
SAN RAFAEL CA
94903-1807
US

IV. Provider business mailing address

1600 LOS GAMOS DR STE 120
SAN RAFAEL CA
94903-1807
US

V. Phone/Fax

Practice location:
  • Phone: 415-444-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: