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General NPI Number Information
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NPI Number | 1295045581
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Entity Type | Individual
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Provider Name | CAROLINE A NOEL PTA
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Gender | Female
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 2059 CLINTON AVE STE 2A
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City | ALAMEDA
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State | CA
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Zip | 94501-4379
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Country | US
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Telephone | 314-442-9704
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Fax |
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Provider Business Mailing Address
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Address Line | 1418 CENTRAL AVE APT 15
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City | ALAMEDA
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State | CA
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Zip | 94501-2456
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Country | US
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Telephone | 314-442-9704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2079241
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 9997
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License Number State | CA
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