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General NPI Number Information
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NPI Number | 1417012428
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Entity Type | Individual
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Provider Name | JANESTA L NOLAND MD
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 401 BURGESS DR STE C
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City | MENLO PARK
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State | CA
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Zip | 94025-3408
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Country | US
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Telephone | 650-321-9555
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Fax | 650-321-9556
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Provider Business Mailing Address
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Address Line | 401 BURGESS DR STE C
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City | MENLO PARK
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State | CA
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Zip | 94025-3408
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Country | US
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Telephone | 650-321-9555
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Fax | 650-321-9556
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A63061
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License Number State | CA
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