Provider Demographics
NPI:1073640124
Name:NOBLE, JEAN (JEAN NOBLE MFT ATRBC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:NOBLE
Suffix:
Gender:F
Credentials:JEAN NOBLE MFT ATRBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SAMOA BLVD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6604
Mailing Address - Country:US
Mailing Address - Phone:707-825-1772
Mailing Address - Fax:
Practice Address - Street 1:920 SAMOA BLVD
Practice Address - Street 2:SUITE 217
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6604
Practice Address - Country:US
Practice Address - Phone:707-825-1772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34324106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist