Provider Demographics
NPI:1053512368
Name:SLADON, NOELLE RAYNE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:RAYNE
Last Name:SLADON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 DONALD DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-6309
Mailing Address - Country:US
Mailing Address - Phone:831-630-9077
Mailing Address - Fax:831-637-8057
Practice Address - Street 1:910 MONTEREY ST
Practice Address - Street 2:#216
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-6309
Practice Address - Country:US
Practice Address - Phone:831-630-9077
Practice Address - Fax:831-637-8057
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist