Basic Information
Provider Information
NPI: 1891810388
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMAS
FirstName: NOELLE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: THOMAS SICK
OtherFirstName: NOEL
OtherMiddleName:  
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 2100 NAPA VALLEJO HWY
Address2:  
City: NAPA
State: CA
PostalCode: 945586293
CountryCode: US
TelephoneNumber: 4082994841
FaxNumber: 4082992511
Practice Location
Address1: 2100 NAPA VALLEJO HWY
Address2:  
City: NAPA
State: CA
PostalCode: 945586293
CountryCode: US
TelephoneNumber: 7072535000
FaxNumber: 7072535097
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 04/01/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804XA76591CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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