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General NPI Number Information
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NPI Number | 1457327074
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Entity Type | Individual
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Provider Name | DENISE RENEE NOLEROTH ATC, MA, CSCS, CMP
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9500 STEARNS AVE
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City | OAKLAND
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State | CA
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Zip | 94605-4720
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Country | US
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Telephone | 510-577-9100
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Fax | 510-638-3259
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Provider Business Mailing Address
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Address Line | 8171 PEPPERTREE CT
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City | DUBLIN
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State | CA
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Zip | 94568-1046
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Country | US
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Telephone | 925-833-9141
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 970443
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License Number State | CA
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