Healthcare Provider Details

I. General information

NPI: 1477478196
Provider Name (Legal Business Name): JOLLIE NOBLEZA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18801 VENTURA BLVD STE 110
TARZANA CA
91356-3361
US

IV. Provider business mailing address

18801 VENTURA BLVD STE 110
TARZANA CA
91356-3361
US

V. Phone/Fax

Practice location:
  • Phone: 818-386-8070
  • Fax:
Mailing address:
  • Phone: 818-386-8070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: