MEDICARE: SAMANTHA NOEGEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	ASW131741	CA
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1477282317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA NOEGEL

Provider Business Mailing Address
First Line	:	1922 THE ALAMEDA STE 316
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1461
Country	:	US
Telephone Number	:	408-261-7777
Fax Number	:	408-642-6052

Provider Business Practice Location Address
First Line	:	436 N WHITE RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-1439
Country	:	US
Telephone Number	:	408-259-0760
Fax Number	:	408-642-6052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	01/12/2026

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Directions to “ SAMANTHA NOEGEL ” Practice Location

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