Provider Demographics
NPI:1235812298
Name:MACE, NOELLE ELIZABETH
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:ELIZABETH
Last Name:MACE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 JANIS CT
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2842
Mailing Address - Country:US
Mailing Address - Phone:925-301-0452
Mailing Address - Fax:
Practice Address - Street 1:877 YGNACIO VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3897
Practice Address - Country:US
Practice Address - Phone:925-482-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician