Provider Demographics
NPI:1457327074
Name:NOLEROTH, DENISE RENEE (ATC, MA, CSCS, CMP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:RENEE
Last Name:NOLEROTH
Suffix:
Gender:F
Credentials:ATC, MA, CSCS, CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8171 PEPPERTREE CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-1046
Mailing Address - Country:US
Mailing Address - Phone:925-833-9141
Mailing Address - Fax:
Practice Address - Street 1:9500 STEARNS AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-4720
Practice Address - Country:US
Practice Address - Phone:510-577-9100
Practice Address - Fax:510-638-3259
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9704432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer